Background: The Global Limb Anatomic Staging System (GLASS) is a new method of quantifying the anatomic severity of infrainguinal disease in patients with chronic limb-threatening ischemia. However, because GLASS has undergone limited validation, its value as an aid to shared decision-making regarding the choice of revascularization strategy remains incompletely defined. Here we report the relationship between GLASS and outcomes in a contemporary series comprising all 309 patients who underwent an attempt at femoropopliteal and/or infrapopiteal endovascular therapy for chronic limb-threatening ischemia in our unit between 2009 and 2014.
Methods: Baseline patient characteristics and outcome data including immediate technical success (ITS), amputation-free survival (AFS), overall survival, limb salvage, freedom from reintervention (FF-R), and freedom from major adverse limb events (FF-MALE) were obtained from hospital databases. GLASS grades and stage were obtained from pre-endovascular therapy angiographic imaging. Outcome data were censored on May 31, 2017.
Results: Baseline patient characteristics were similar across different GLASS femoropopliteal and IP grades and overall limb stages. Worsening GLASS stage was associated with a significant reduction in ITS (97.5% vs 91.5% vs 84.0%; P = .029). At 72 months FF-R (hazard ratio, 2.00; 95% confidence interval, 1.11-3.57; P = .020) and FF-MALE (hazard ratio, 1.76, 95% confidence interval, 1.10-2.81; P = .019) were significant worse in GLASS stage 3 than in stage 2 limbs.
Conclusions: In our study, there were significant differences in ITS, FF-R and FF-MALE between limbs with GLASS stage 2 and 3 disease. However, further GLASS refinement seems likely to be required if its usefulness in everyday clinical practice as an aid to shared decision-making regarding the choice of revascularization strategy is to be maximized.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jvs.2022.07.188 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Benefits of Duplex Ultrasound Surveillance of infra-inguinal bypass grafts and institutional costs of graft failure: a retrospective single-centre study.
Ann Vasc Surg
January 2025
The Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds, LS1 3EX, UK. Electronic address:
Objective: The Achilles' heel of infrainguinal bypass grafts (IIBG) is restenosis. Duplex ultrasound (DUS) surveillance is commonly undertaken to identify restenosis allowing intervention for graft salvage. We report the impact of DUS surveillance on patient outcomes alongside healthcare-associated costs.
View Article and Find Full Text PDFAssociation of Chronic Limb Ischemia Rutherford Classification with Clinical Outcomes Following Lower Extremity Revascularization.
Ann Vasc Surg
January 2025
Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA. Electronic address:
Introduction: The Rutherford Classification for chronic limb-threatening ischemia (CLTI) is used to categorize peripheral artery disease severity through history and physical examination. This study investigated whether higher Rutherford Classification correlates with worse clinical outcomes and could serve as a predictive tool.
Methods: In this prospective single-center study , 252 patients undergoing lower extremity revascularization were followed for three years (2020-2023).
Two-Year Outcomes of Excimer Laser Ablation Combined with Drug-Coated Balloon for Treating De novo Lesions and In-Stent Restenosis in Femoropopliteal Artery of Chronic Limb-Threatening Ischemia Patients.
Ann Vasc Surg
January 2025
Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, 100053. Electronic address:
Objective: To evaluate the safety and efficacy of excimer laser ablation (ELA) combined with drug-coated balloon(DCB)in the treatment of Chronic limb-threatening ischemia (CLTI) patients with de novo and in-stent restenosis (ISR) lesions in the femoropopliteal artery.
Methods: A retrospective, single-center analysis was performed on data collected between January 2017 and December 2021. The study included CLTI patients who underwent treatment with ELA combined with DCB for de novo and ISR lesions in the femoropopliteal artery.
Evaluation of autologous venous allograft for lower limb in the treatment of critical limb ischemia. The REVATEC (REVAscularisation par greffons veineux bioproTEC) study.
Ann Vasc Surg
January 2025
Department of Vascular and Endovascular Surgery - Tertiary Aortic Center, Pitie-Salpêtrière University Hospital, 47-83 Bd de l'Hôpital, Paris, France; Sorbonne Université, Paris, France. Electronic address:
Objective: Chronic limb-threatening ischemia (CLTI) requires revascularization whenever it is possible. The great saphenous vein represents the surgical conduit of choice. However, it is not always available, in particular in multi-operated patients.
View Article and Find Full Text PDFIncense Use and the Risk of Chronic Limb-Threatening Ischemia Among Middle-Aged and Older Adults in the Singapore Chinese Health Study.
Environ Health Perspect
January 2025
Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Background: Epidemiologic studies have shown that daily exposure to incense smoke is associated with greater risk of cardiovascular mortality, which suggests that chronic exposure to incense could be linked to atherosclerosis. We studied the association between home incense use and the risk of chronic limb-threatening ischemia (CLTI), the most severe outcome of peripheral arterial disease.
Methods: We used data from the Singapore Chinese Health Study, which recruited 63,257 Chinese participants 45-74 years old from 1993-1998.
Want 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!