Is atherectomy the best first-line therapy for limb salvage in patients with critical limb Ischemia?

Gabriel Loor, Christopher L. Skelly, Carl Magnus Wahlgren, Hisham S. Bassiouny, Giancarlo Piano, Wael Shaalan, Tina R. Desai

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Objective: To determine the efficacy of atherectomy for limb salvage compared with open bypass in patients with critical limb ischemia. Methods: Ninety-nine consecutive bypass and atherectomy procedures performed for critical limb ischemia between January 2003 and October 2006 were reviewed. Results: A total of 99 cases involving TASC C (n = 43, 44%) and D (n = 56, 56%) lesions were treated with surgical bypass in 59 patients and atherectomy in 33 patients. Bypass and atherectomy achieved similar 1-year primary patency (64% vs 63%; P =.2). However, the 1-year limb salvage rate was greater in the bypass group (87% vs 69%; P =.004). In the tissue loss subgroup, there was a greater limb salvage rate for bypass patients versus atherectomy (79% vs 60%; P =.04). Conclusions: Patients with critical limb ischemia may do better with open bypass compared with atherectomy as first-line therapy for limb salvage.

Original languageEnglish (US)
Pages (from-to)542-550
Number of pages9
JournalVascular and Endovascular Surgery
Volume43
Issue number6
DOIs
StatePublished - Dec 2009

Bibliographical note

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • Amputation
  • Angioplasty
  • Atherosclerosis
  • Claudication
  • Ischemia
  • Leg ulcer
  • Lower extremity
  • Peripheral arterial disease

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