Objective: The aim was to compare outcomes in a subgroup of patients with infrapopliteal (IP) disease randomised to infrapopliteal vein bypass (VB) or plain balloon angioplasty (PBA) in the original BASIL trial.
Methods: A comparison of outcomes from patients randomised to VB or PBA undergoing revascularisation for severe limb ischaemia (SLI) because of IP disease with or without femoropopliteal disease. Data were extracted from case report forms from the BASIL trial. The primary outcome was amputation free survival (AFS); secondary outcomes included overall survival (OS), 30 day mortality and morbidity, freedom from arterial re-intervention, immediate technical success, repeat and crossover interventions, length of hospital stay, and quality of revascularisation.
Results: A total of 104 patients were identified in the BASIL study with IP disease, 56 randomised to IP VB, and 48 to IP PBA. Groups were similar at baseline except for more chronic kidney disease and non-steroidal anti-inflammatory drug use in the VB group, and more previous surgical arterial intervention and antihypertensive use in the PBA group. There were no statistically significant differences in AFS or OS; however, clinically important trends were apparent in favour of a VB first strategy. Patients allocated to VB demonstrated significantly quicker relief of rest pain when compared with PBA (p = .005), but no significant differences in improved tissue healing. Median length of index hospital admission was significantly greater in the VB than in the PBA group (18 vs. 10 days, p < .0001) but there was no difference between the two groups in median total hospital stay between randomisation and the primary endpoint (VB 43.5 vs. PBA 42 days).
Conclusions: Further randomised trials, like BASIL-2 and BEST-CLI, are required to determine whether patients with severe limb ischaemia who require IP revascularisation and who are suitable for VB should have bypass or endovascular intervention as their primary revascularisation procedure.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ejvs.2017.04.020 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Posterior Peroral Endoscopic Myotomy With Versus Without Sparing of the Oblique/Sling Fibers: A Meta-analysis.
Surg Laparosc Endosc Percutan Tech
January 2025
Department of Surgery, Division of Gastrointestinal Surgery, University of South Florida, Morsani College of Medicine, Tampa, FL.
Background And Aims: Several studies have hypothesized that sparing the oblique/sling fibers during posterior peroral endoscopic myotomy (POEM) may reduce the incidence of gastroesophageal reflux disease (GERD) and reflux esophagitis without compromising the established safety and efficacy of the procedure. This study compares perioperative, postoperative motility-related, and postoperative GERD-related outcomes between posterior oblique/sling fibers-sparing POEM (OFS-POEM) and conventional posterior POEM through a pairwise meta-analysis of comparative studies.
Methods: We conducted a systematic literature review following PRISMA guidelines to identify articles directly comparing posterior OFS-POEM with conventional posterior POEM.
Performance of an Algorithm Grading Surgery-Related Adverse Events According to the Clavien-Dindo Classification.
Ann Surg
January 2025
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Objective: To assess performance of an algorithm for automated grading of surgery-related adverse events (AEs) according to Clavien-Dindo (C-D) classification.
Summary Background Data: Surgery-related AEs are common, lead to increased morbidity for patients, and raise healthcare costs. Resource-intensive manual chart review is still standard and to our knowledge algorithms using electronic health record (EHR) data to grade AEs according to C-D classification have not been explored.
Investigating the effect of yoga-based educational interventions on the volume and composition of breast milk in premature infant's mothers admitted to neonatal intensive care unit: A randomized controlled trial.
J Educ Health Promot
November 2024
Department of Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
Background: This study examined the effects of yoga-based educational interventions on the volume and composition of breast milk in premature infants' mothers admitted to the neonatal intensive care unit (NICU).
Materials And Methods: A randomized controlled trial was conducted on 78 primiparous mothers whose premature infants were less than 34 weeks and were hospitalized in the NICU of Ayatollah Rouhani Hospital from February 2021 to November 2022. Mothers were assigned to a control group and an experimental group, that is, yoga, using the block randomization method.
The effects of synbiotic supplementation along with non-surgical periodontal therapy in improving the metabolic status and inflammatory markers in type 2 diabetes mellitus patients with periodontal disease: A double-blind randomized clinical trial.
J Educ Health Promot
November 2024
Department of Biostatistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Background: Diabetes mellitus and periodontitis are two common chronic diseases with bidirectional relationship. Considering the role of oxidative stress in the pathogenesis of these two diseases, the use of nutritional supplements with antioxidant properties can be useful. The purpose of this study was to determine the effectiveness of daily synbiotic supplement in the management of patients with type 2 diabetes mellitus (T2DM) and periodontal disease (PD) under non-surgical periodontal therapy (NSPT).
View Article and Find Full Text PDFProtocol of randomized controlled trial to evaluate the effect of moderate exercise training on the functional capacity of patients with an implantable cardioverter defibrillator in a tertiary care center in South India.
J Educ Health Promot
November 2024
Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Background: Cardiac rehabilitation programs are planned to reduce the physiological and psychological stress of Cardiovascular Disease, decrease the risk of mortality secondary to CVD, improve cardiovascular function, and help patients to achieve their highest quality of life. However, data on the safety and efficacy of exercise training (ET) in patients with implantable cardioverter defibrillators (ICDs) is sparse. Exercise interventions in those with an ICD have not been extensively studied.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!