A comparison between combined open bypass revascularization and free tissue transfer versus endovascular revascularization and free tissue transfer for lower limb preservation
Background Extensive defects of the lower limb as a result of diabetes and peripheral vascular disease require multidisciplinary treatment. Numerous studies with regards combining vascular bypass surgery and free tissue reconstruction of the lower limb had been published. However the trend has evolv...
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| Veröffentlicht in: | Microsurgery 2015-10, Vol.35 (7), p.518-527 |
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| creator | Hsu, Honda Chang, Chien-Hwa Lee, Cheng-Yung Huang, Chieh-Chi Mark Chiu, Chih-Hung Lin, Chih-Ming Lee, Jiunn-Tat Chien, Sou-Hsin |
| description | Background
Extensive defects of the lower limb as a result of diabetes and peripheral vascular disease require multidisciplinary treatment. Numerous studies with regards combining vascular bypass surgery and free tissue reconstruction of the lower limb had been published. However the trend has evolved toward a combination of endovascular revascularization and free flap reconstruction. The aim of this study was to compare the safety and efficacy of this combination of treatment to the traditional combination of bypass surgery and free tissue reconstruction.
Methods
All patients who had undergone vascular bypass surgery and free tissue reconstruction of the lower limb as well as those who had undergone endovascular angioplasty with free tissue transfer for lower limb preservation, over a 10‐year period was included in this study.
Results
A total of 46 patients that underwent limb preservation were included in this study, 22 patients underwent open bypass revascularization and free flap transfer and 24 patients underwent endovascular revascularization and free tissue transfer. There were no differences between the two methods with regards to age, sex, defect size, TransAtlantic InterSociety Consensus level, Wagner classification, length of hospitalization, limb preservation rate, total flap necrosis rate, and partial flap necrosis rate. More importantly, there was no significant difference in the limb preservation rate (P = 0.14).
Conclusion
In this study we found that the safety and the success rate of lower limb preservation using a combination of endovascular revascularization and free tissue reconstruction is comparable to using a combination of bypass surgery and free tissue transfer. © 2015 Wiley Periodicals, Inc. Microsurgery 35:518–527, 2015. |
| doi_str_mv | 10.1002/micr.22475 |
| format | Article |
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Extensive defects of the lower limb as a result of diabetes and peripheral vascular disease require multidisciplinary treatment. Numerous studies with regards combining vascular bypass surgery and free tissue reconstruction of the lower limb had been published. However the trend has evolved toward a combination of endovascular revascularization and free flap reconstruction. The aim of this study was to compare the safety and efficacy of this combination of treatment to the traditional combination of bypass surgery and free tissue reconstruction.
Methods
All patients who had undergone vascular bypass surgery and free tissue reconstruction of the lower limb as well as those who had undergone endovascular angioplasty with free tissue transfer for lower limb preservation, over a 10‐year period was included in this study.
Results
A total of 46 patients that underwent limb preservation were included in this study, 22 patients underwent open bypass revascularization and free flap transfer and 24 patients underwent endovascular revascularization and free tissue transfer. There were no differences between the two methods with regards to age, sex, defect size, TransAtlantic InterSociety Consensus level, Wagner classification, length of hospitalization, limb preservation rate, total flap necrosis rate, and partial flap necrosis rate. More importantly, there was no significant difference in the limb preservation rate (P = 0.14).
Conclusion
In this study we found that the safety and the success rate of lower limb preservation using a combination of endovascular revascularization and free tissue reconstruction is comparable to using a combination of bypass surgery and free tissue transfer. © 2015 Wiley Periodicals, Inc. Microsurgery 35:518–527, 2015.</description><identifier>ISSN: 0738-1085</identifier><identifier>EISSN: 1098-2752</identifier><identifier>DOI: 10.1002/micr.22475</identifier><identifier>PMID: 26361236</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Diabetic Foot - surgery ; Endovascular Procedures - methods ; Female ; Free Tissue Flaps - transplantation ; Humans ; Limb Salvage - methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Vascular Grafting - methods</subject><ispartof>Microsurgery, 2015-10, Vol.35 (7), p.518-527</ispartof><rights>2015 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4655-3e23e8ecece5e6db9e9e12f9d6e088dca026455697e20c624aa546e96803acbf3</citedby><cites>FETCH-LOGICAL-c4655-3e23e8ecece5e6db9e9e12f9d6e088dca026455697e20c624aa546e96803acbf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmicr.22475$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmicr.22475$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27913,27914,45563,45564</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26361236$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsu, Honda</creatorcontrib><creatorcontrib>Chang, Chien-Hwa</creatorcontrib><creatorcontrib>Lee, Cheng-Yung</creatorcontrib><creatorcontrib>Huang, Chieh-Chi</creatorcontrib><creatorcontrib>Mark Chiu, Chih-Hung</creatorcontrib><creatorcontrib>Lin, Chih-Ming</creatorcontrib><creatorcontrib>Lee, Jiunn-Tat</creatorcontrib><creatorcontrib>Chien, Sou-Hsin</creatorcontrib><title>A comparison between combined open bypass revascularization and free tissue transfer versus endovascular revascularization and free tissue transfer for lower limb preservation</title><title>Microsurgery</title><addtitle>Microsurgery</addtitle><description>Background
Extensive defects of the lower limb as a result of diabetes and peripheral vascular disease require multidisciplinary treatment. Numerous studies with regards combining vascular bypass surgery and free tissue reconstruction of the lower limb had been published. However the trend has evolved toward a combination of endovascular revascularization and free flap reconstruction. The aim of this study was to compare the safety and efficacy of this combination of treatment to the traditional combination of bypass surgery and free tissue reconstruction.
Methods
All patients who had undergone vascular bypass surgery and free tissue reconstruction of the lower limb as well as those who had undergone endovascular angioplasty with free tissue transfer for lower limb preservation, over a 10‐year period was included in this study.
Results
A total of 46 patients that underwent limb preservation were included in this study, 22 patients underwent open bypass revascularization and free flap transfer and 24 patients underwent endovascular revascularization and free tissue transfer. There were no differences between the two methods with regards to age, sex, defect size, TransAtlantic InterSociety Consensus level, Wagner classification, length of hospitalization, limb preservation rate, total flap necrosis rate, and partial flap necrosis rate. More importantly, there was no significant difference in the limb preservation rate (P = 0.14).
Conclusion
In this study we found that the safety and the success rate of lower limb preservation using a combination of endovascular revascularization and free tissue reconstruction is comparable to using a combination of bypass surgery and free tissue transfer. © 2015 Wiley Periodicals, Inc. Microsurgery 35:518–527, 2015.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Diabetic Foot - surgery</subject><subject>Endovascular Procedures - methods</subject><subject>Female</subject><subject>Free Tissue Flaps - transplantation</subject><subject>Humans</subject><subject>Limb Salvage - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Vascular Grafting - methods</subject><issn>0738-1085</issn><issn>1098-2752</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkcuKFDEUhoMoTs_oxgeQgBsRasylkkqWY6PtyHhBFN2FVOoUZKyqlElV97Qv5Sua7p6ehQtBsjhJ-L6fAz9CTyg5p4Swl7138ZyxshL30IISrQpWCXYfLUjFVUGJEifoNKVrQojWlX6ITpjkkjIuF-j3BXahH230KQy4hmkDMOy-aj9Ag8OYX_V2tCnhCGub3Nxl9pedfMbt0OA2AuDJpzTnEe2QWoh4DTHNCcPQhKPzP3obIu7CJt8639d4jJAgrvfSI_SgtV2Cx7fzDH198_rL8m1x9XF1uby4KlwphSg4MA4KXD4CZFNr0EBZqxsJRKnGWcJkKYTUFTDiJCutFaUELRXh1tUtP0PPD7ljDD9nSJPpfXLQdXaAMCdDK8Y006VSGX32F3od5jjk7faULDmhZaZeHCgXQ0oRWjNG39u4NZSYXY1mV6PZ15jhp7eRc91Dc4cee8sAPQAb38H2H1Hm_eXy8zG0ODg-TXBz59j4w8iKZ_Tbh5UR31fqFflEzDv-B82cvKs</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Hsu, Honda</creator><creator>Chang, Chien-Hwa</creator><creator>Lee, Cheng-Yung</creator><creator>Huang, Chieh-Chi</creator><creator>Mark Chiu, Chih-Hung</creator><creator>Lin, Chih-Ming</creator><creator>Lee, Jiunn-Tat</creator><creator>Chien, Sou-Hsin</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201510</creationdate><title>A comparison between combined open bypass revascularization and free tissue transfer versus endovascular revascularization and free tissue transfer for lower limb preservation</title><author>Hsu, Honda ; Chang, Chien-Hwa ; Lee, Cheng-Yung ; Huang, Chieh-Chi ; Mark Chiu, Chih-Hung ; Lin, Chih-Ming ; Lee, Jiunn-Tat ; Chien, Sou-Hsin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4655-3e23e8ecece5e6db9e9e12f9d6e088dca026455697e20c624aa546e96803acbf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Diabetic Foot - surgery</topic><topic>Endovascular Procedures - methods</topic><topic>Female</topic><topic>Free Tissue Flaps - transplantation</topic><topic>Humans</topic><topic>Limb Salvage - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Vascular Grafting - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hsu, Honda</creatorcontrib><creatorcontrib>Chang, Chien-Hwa</creatorcontrib><creatorcontrib>Lee, Cheng-Yung</creatorcontrib><creatorcontrib>Huang, Chieh-Chi</creatorcontrib><creatorcontrib>Mark Chiu, Chih-Hung</creatorcontrib><creatorcontrib>Lin, Chih-Ming</creatorcontrib><creatorcontrib>Lee, Jiunn-Tat</creatorcontrib><creatorcontrib>Chien, Sou-Hsin</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Microsurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hsu, Honda</au><au>Chang, Chien-Hwa</au><au>Lee, Cheng-Yung</au><au>Huang, Chieh-Chi</au><au>Mark Chiu, Chih-Hung</au><au>Lin, Chih-Ming</au><au>Lee, Jiunn-Tat</au><au>Chien, Sou-Hsin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison between combined open bypass revascularization and free tissue transfer versus endovascular revascularization and free tissue transfer for lower limb preservation</atitle><jtitle>Microsurgery</jtitle><addtitle>Microsurgery</addtitle><date>2015-10</date><risdate>2015</risdate><volume>35</volume><issue>7</issue><spage>518</spage><epage>527</epage><pages>518-527</pages><issn>0738-1085</issn><eissn>1098-2752</eissn><abstract>Background
Extensive defects of the lower limb as a result of diabetes and peripheral vascular disease require multidisciplinary treatment. Numerous studies with regards combining vascular bypass surgery and free tissue reconstruction of the lower limb had been published. However the trend has evolved toward a combination of endovascular revascularization and free flap reconstruction. The aim of this study was to compare the safety and efficacy of this combination of treatment to the traditional combination of bypass surgery and free tissue reconstruction.
Methods
All patients who had undergone vascular bypass surgery and free tissue reconstruction of the lower limb as well as those who had undergone endovascular angioplasty with free tissue transfer for lower limb preservation, over a 10‐year period was included in this study.
Results
A total of 46 patients that underwent limb preservation were included in this study, 22 patients underwent open bypass revascularization and free flap transfer and 24 patients underwent endovascular revascularization and free tissue transfer. There were no differences between the two methods with regards to age, sex, defect size, TransAtlantic InterSociety Consensus level, Wagner classification, length of hospitalization, limb preservation rate, total flap necrosis rate, and partial flap necrosis rate. More importantly, there was no significant difference in the limb preservation rate (P = 0.14).
Conclusion
In this study we found that the safety and the success rate of lower limb preservation using a combination of endovascular revascularization and free tissue reconstruction is comparable to using a combination of bypass surgery and free tissue transfer. © 2015 Wiley Periodicals, Inc. Microsurgery 35:518–527, 2015.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>26361236</pmid><doi>10.1002/micr.22475</doi><tpages>10</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Diabetic Foot - surgery Endovascular Procedures - methods Female Free Tissue Flaps - transplantation Humans Limb Salvage - methods Male Middle Aged Retrospective Studies Treatment Outcome Vascular Grafting - methods |
| title | A comparison between combined open bypass revascularization and free tissue transfer versus endovascular revascularization and free tissue transfer for lower limb preservation |
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