Autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene as graft materials for below-the-knee femoro-popliteal bypass in patients with critical limb ischemia: A propensity score-matched analysis
To compare the outcomes of heparin bonded expanded polytetrafluoroethylene (HePTFE) and autologous saphenous vein (ASV) in patients undergoing below-knee (BK) femoro-popliteal bypass for critical limb ischemia (CLI). Retrospective single-centre matched case–control study. From 2003 to 2019, 275 cons...
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| Veröffentlicht in: | The surgeon (Edinburgh) 2022-04, Vol.20 (2), p.85-93 |
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| creator | Dorigo, Walter Fargion, Aaron Bassoli, Giulia Di Domenico, Rossella Giacomelli, Elena Piffaretti, Gabriele Alessi Innocenti, Alessandro Pratesi, Carlo |
| description | To compare the outcomes of heparin bonded expanded polytetrafluoroethylene (HePTFE) and autologous saphenous vein (ASV) in patients undergoing below-knee (BK) femoro-popliteal bypass for critical limb ischemia (CLI).
Retrospective single-centre matched case–control study.
From 2003 to 2019, 275 consecutive BK bypasses for CLI were performed, 109 with the ASV and 166 with a HePTFE graft. All the baseline characteristics that were reliably measured and were potentially relevant in the decision-making process were included as confounders in a logistic regression model and the factors that were significantly different between the two groups then used to perform a propensity matching analysis. Propensity score-based matching was performed in a 1:1 ratio to compare outcomes. Arterial hypertension, hyperlipemia, the need for tibial anastomosis at the distal level and the run-off status were the covariates included in the matching. Follow-up outcomes were estimated by Kaplan–Meier methods and compared with log rank test.
After propensity matching, 101 HePTFE bypasses were matched with 101 ASV bypasses. The median duration of follow-up was 37 months (range 1–192). The 5-year survival rate was 67.5% (standard error (SE) 0.05) in the HePTFe group and 64.5% (SE 0.06) in the ASV group (p = 0.8, log rank 0.04). Primary patency rates were 38% (SE 0.06) in the HePTFE group and 41% (SE 0.06) in the ASV group (p = 0.7, log rank 0.3). Also assisted primary patency and secondary patency rates did not differ in the two groups. Amputation-free survival was 53% (SE 0.05) in the HePTFE group and 58% (SE 0.06) in the ASF group (p = 0.6, log rank 0.2).
HePTFE provided 5-year similar results to those obtained with use of the ASV in equivalent patients with CLI undergoing below-knee or tibial bypass.
•Retrospective single-centre matched case–control study•HePTFE and ASV were compared in CLI patients undergoing BK bypass•The two materials provided similar 5-years results in equivalent patients•HePTFE could be potentially used in all the patients without an optimal ASV•The authors support the need for new prospective RCTs |
| doi_str_mv | 10.1016/j.surge.2021.02.001 |
| format | Article |
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Retrospective single-centre matched case–control study.
From 2003 to 2019, 275 consecutive BK bypasses for CLI were performed, 109 with the ASV and 166 with a HePTFE graft. All the baseline characteristics that were reliably measured and were potentially relevant in the decision-making process were included as confounders in a logistic regression model and the factors that were significantly different between the two groups then used to perform a propensity matching analysis. Propensity score-based matching was performed in a 1:1 ratio to compare outcomes. Arterial hypertension, hyperlipemia, the need for tibial anastomosis at the distal level and the run-off status were the covariates included in the matching. Follow-up outcomes were estimated by Kaplan–Meier methods and compared with log rank test.
After propensity matching, 101 HePTFE bypasses were matched with 101 ASV bypasses. The median duration of follow-up was 37 months (range 1–192). The 5-year survival rate was 67.5% (standard error (SE) 0.05) in the HePTFe group and 64.5% (SE 0.06) in the ASV group (p = 0.8, log rank 0.04). Primary patency rates were 38% (SE 0.06) in the HePTFE group and 41% (SE 0.06) in the ASV group (p = 0.7, log rank 0.3). Also assisted primary patency and secondary patency rates did not differ in the two groups. Amputation-free survival was 53% (SE 0.05) in the HePTFE group and 58% (SE 0.06) in the ASF group (p = 0.6, log rank 0.2).
HePTFE provided 5-year similar results to those obtained with use of the ASV in equivalent patients with CLI undergoing below-knee or tibial bypass.
•Retrospective single-centre matched case–control study•HePTFE and ASV were compared in CLI patients undergoing BK bypass•The two materials provided similar 5-years results in equivalent patients•HePTFE could be potentially used in all the patients without an optimal ASV•The authors support the need for new prospective RCTs</description><identifier>ISSN: 1479-666X</identifier><identifier>EISSN: 2405-5840</identifier><identifier>DOI: 10.1016/j.surge.2021.02.001</identifier><identifier>PMID: 33685832</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Anticoagulants - therapeutic use ; Autologous vein ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Case-Control Studies ; Chronic Limb-Threatening Ischemia ; Coated Materials, Biocompatible ; Comparison ; Critical limb ischemia ; Heparin ; Heparin bonded ePTFE ; Humans ; Infrainguinal bypass ; Ischemia - surgery ; Limb Salvage ; Polytetrafluoroethylene ; Propensity Score ; Prosthesis Design ; Retrospective Studies ; Saphenous Vein - surgery ; Saphenous Vein - transplantation ; Treatment Outcome ; Vascular Patency</subject><ispartof>The surgeon (Edinburgh), 2022-04, Vol.20 (2), p.85-93</ispartof><rights>2021 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland</rights><rights>Copyright © 2021 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-f825b2c8e8763ce4d7f5fe75b2750a25af77de2fe1f4eb42b0e30e462a37af7a3</citedby><cites>FETCH-LOGICAL-c359t-f825b2c8e8763ce4d7f5fe75b2750a25af77de2fe1f4eb42b0e30e462a37af7a3</cites><orcidid>0000-0003-1985-6434 ; 0000-0003-3814-5961</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1479666X2100038X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33685832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dorigo, Walter</creatorcontrib><creatorcontrib>Fargion, Aaron</creatorcontrib><creatorcontrib>Bassoli, Giulia</creatorcontrib><creatorcontrib>Di Domenico, Rossella</creatorcontrib><creatorcontrib>Giacomelli, Elena</creatorcontrib><creatorcontrib>Piffaretti, Gabriele</creatorcontrib><creatorcontrib>Alessi Innocenti, Alessandro</creatorcontrib><creatorcontrib>Pratesi, Carlo</creatorcontrib><title>Autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene as graft materials for below-the-knee femoro-popliteal bypass in patients with critical limb ischemia: A propensity score-matched analysis</title><title>The surgeon (Edinburgh)</title><addtitle>Surgeon</addtitle><description>To compare the outcomes of heparin bonded expanded polytetrafluoroethylene (HePTFE) and autologous saphenous vein (ASV) in patients undergoing below-knee (BK) femoro-popliteal bypass for critical limb ischemia (CLI).
Retrospective single-centre matched case–control study.
From 2003 to 2019, 275 consecutive BK bypasses for CLI were performed, 109 with the ASV and 166 with a HePTFE graft. All the baseline characteristics that were reliably measured and were potentially relevant in the decision-making process were included as confounders in a logistic regression model and the factors that were significantly different between the two groups then used to perform a propensity matching analysis. Propensity score-based matching was performed in a 1:1 ratio to compare outcomes. Arterial hypertension, hyperlipemia, the need for tibial anastomosis at the distal level and the run-off status were the covariates included in the matching. Follow-up outcomes were estimated by Kaplan–Meier methods and compared with log rank test.
After propensity matching, 101 HePTFE bypasses were matched with 101 ASV bypasses. The median duration of follow-up was 37 months (range 1–192). The 5-year survival rate was 67.5% (standard error (SE) 0.05) in the HePTFe group and 64.5% (SE 0.06) in the ASV group (p = 0.8, log rank 0.04). Primary patency rates were 38% (SE 0.06) in the HePTFE group and 41% (SE 0.06) in the ASV group (p = 0.7, log rank 0.3). Also assisted primary patency and secondary patency rates did not differ in the two groups. Amputation-free survival was 53% (SE 0.05) in the HePTFE group and 58% (SE 0.06) in the ASF group (p = 0.6, log rank 0.2).
HePTFE provided 5-year similar results to those obtained with use of the ASV in equivalent patients with CLI undergoing below-knee or tibial bypass.
•Retrospective single-centre matched case–control study•HePTFE and ASV were compared in CLI patients undergoing BK bypass•The two materials provided similar 5-years results in equivalent patients•HePTFE could be potentially used in all the patients without an optimal ASV•The authors support the need for new prospective RCTs</description><subject>Anticoagulants - therapeutic use</subject><subject>Autologous vein</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Case-Control Studies</subject><subject>Chronic Limb-Threatening Ischemia</subject><subject>Coated Materials, Biocompatible</subject><subject>Comparison</subject><subject>Critical limb ischemia</subject><subject>Heparin</subject><subject>Heparin bonded ePTFE</subject><subject>Humans</subject><subject>Infrainguinal bypass</subject><subject>Ischemia - surgery</subject><subject>Limb Salvage</subject><subject>Polytetrafluoroethylene</subject><subject>Propensity Score</subject><subject>Prosthesis Design</subject><subject>Retrospective Studies</subject><subject>Saphenous Vein - surgery</subject><subject>Saphenous Vein - transplantation</subject><subject>Treatment Outcome</subject><subject>Vascular Patency</subject><issn>1479-666X</issn><issn>2405-5840</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAQtRCIbgu_AAn5yMXBsfOJxGFVQUGqxAUkbpbjjDdenNjYTkv-KT8Hb7dw5OTRzHt-b-Yh9KqkRUnL5u2xiGs4QMEoKwvKCkrLJ2jHKlqTuqvoU7Qrq7YnTdN8v0CXMR4pZTWn9XN0wXnT1R1nO_R7vyZn3cGtEUfpJ1hO1R2YBctlxBN4GcxCBreMMGL45eVD4Z3dEqQgtV1dcJCmzcICWEZ8yM2EZ5kgGGkj1i7gAay7J2kC8mMBwBrmTCLeeWsSSIuHzcsYcRb1MhlYUsT3Jk1YBZOMygBr5gGbqCaYjXyH99gH52GJJm04KheAZME8HbNrabdo4gv0TGd5ePn4XqFvHz98vf5Ebr_cfL7e3xLF6z4R3bF6YKqDrm24gmpsda2hzb22ppLVUrftCExDqSsYKjZQ4BSqhkne5pnkV-jN-d_s6OcKMYk5-wRr5QL5lIJVfc-7pq_aDOVnqAouxgBa-GBmGTZRUnGKVBzFQ6TiFKmgTORIM-v1o8A6zDD-4_zNMAPenwGQ17wzEERU-YYKRhNAJTE681-BP_Bdu-0</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Dorigo, Walter</creator><creator>Fargion, Aaron</creator><creator>Bassoli, Giulia</creator><creator>Di Domenico, Rossella</creator><creator>Giacomelli, Elena</creator><creator>Piffaretti, Gabriele</creator><creator>Alessi Innocenti, Alessandro</creator><creator>Pratesi, Carlo</creator><general>Elsevier Ltd</general><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>7X8</scope><orcidid>https://orcid.org/0000-0003-1985-6434</orcidid><orcidid>https://orcid.org/0000-0003-3814-5961</orcidid></search><sort><creationdate>202204</creationdate><title>Autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene as graft materials for below-the-knee femoro-popliteal bypass in patients with critical limb ischemia: A propensity score-matched analysis</title><author>Dorigo, Walter ; Fargion, Aaron ; Bassoli, Giulia ; Di Domenico, Rossella ; Giacomelli, Elena ; Piffaretti, Gabriele ; Alessi Innocenti, Alessandro ; Pratesi, Carlo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-f825b2c8e8763ce4d7f5fe75b2750a25af77de2fe1f4eb42b0e30e462a37af7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anticoagulants - therapeutic use</topic><topic>Autologous vein</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Case-Control Studies</topic><topic>Chronic Limb-Threatening Ischemia</topic><topic>Coated Materials, Biocompatible</topic><topic>Comparison</topic><topic>Critical limb ischemia</topic><topic>Heparin</topic><topic>Heparin bonded ePTFE</topic><topic>Humans</topic><topic>Infrainguinal bypass</topic><topic>Ischemia - surgery</topic><topic>Limb Salvage</topic><topic>Polytetrafluoroethylene</topic><topic>Propensity Score</topic><topic>Prosthesis Design</topic><topic>Retrospective Studies</topic><topic>Saphenous Vein - surgery</topic><topic>Saphenous Vein - transplantation</topic><topic>Treatment Outcome</topic><topic>Vascular Patency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dorigo, Walter</creatorcontrib><creatorcontrib>Fargion, Aaron</creatorcontrib><creatorcontrib>Bassoli, Giulia</creatorcontrib><creatorcontrib>Di Domenico, Rossella</creatorcontrib><creatorcontrib>Giacomelli, Elena</creatorcontrib><creatorcontrib>Piffaretti, Gabriele</creatorcontrib><creatorcontrib>Alessi Innocenti, Alessandro</creatorcontrib><creatorcontrib>Pratesi, Carlo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The surgeon (Edinburgh)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dorigo, Walter</au><au>Fargion, Aaron</au><au>Bassoli, Giulia</au><au>Di Domenico, Rossella</au><au>Giacomelli, Elena</au><au>Piffaretti, Gabriele</au><au>Alessi Innocenti, Alessandro</au><au>Pratesi, Carlo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene as graft materials for below-the-knee femoro-popliteal bypass in patients with critical limb ischemia: A propensity score-matched analysis</atitle><jtitle>The surgeon (Edinburgh)</jtitle><addtitle>Surgeon</addtitle><date>2022-04</date><risdate>2022</risdate><volume>20</volume><issue>2</issue><spage>85</spage><epage>93</epage><pages>85-93</pages><issn>1479-666X</issn><eissn>2405-5840</eissn><abstract>To compare the outcomes of heparin bonded expanded polytetrafluoroethylene (HePTFE) and autologous saphenous vein (ASV) in patients undergoing below-knee (BK) femoro-popliteal bypass for critical limb ischemia (CLI).
Retrospective single-centre matched case–control study.
From 2003 to 2019, 275 consecutive BK bypasses for CLI were performed, 109 with the ASV and 166 with a HePTFE graft. All the baseline characteristics that were reliably measured and were potentially relevant in the decision-making process were included as confounders in a logistic regression model and the factors that were significantly different between the two groups then used to perform a propensity matching analysis. Propensity score-based matching was performed in a 1:1 ratio to compare outcomes. Arterial hypertension, hyperlipemia, the need for tibial anastomosis at the distal level and the run-off status were the covariates included in the matching. Follow-up outcomes were estimated by Kaplan–Meier methods and compared with log rank test.
After propensity matching, 101 HePTFE bypasses were matched with 101 ASV bypasses. The median duration of follow-up was 37 months (range 1–192). The 5-year survival rate was 67.5% (standard error (SE) 0.05) in the HePTFe group and 64.5% (SE 0.06) in the ASV group (p = 0.8, log rank 0.04). Primary patency rates were 38% (SE 0.06) in the HePTFE group and 41% (SE 0.06) in the ASV group (p = 0.7, log rank 0.3). Also assisted primary patency and secondary patency rates did not differ in the two groups. Amputation-free survival was 53% (SE 0.05) in the HePTFE group and 58% (SE 0.06) in the ASF group (p = 0.6, log rank 0.2).
HePTFE provided 5-year similar results to those obtained with use of the ASV in equivalent patients with CLI undergoing below-knee or tibial bypass.
•Retrospective single-centre matched case–control study•HePTFE and ASV were compared in CLI patients undergoing BK bypass•The two materials provided similar 5-years results in equivalent patients•HePTFE could be potentially used in all the patients without an optimal ASV•The authors support the need for new prospective RCTs</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>33685832</pmid><doi>10.1016/j.surge.2021.02.001</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1985-6434</orcidid><orcidid>https://orcid.org/0000-0003-3814-5961</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | The surgeon (Edinburgh), 2022-04, Vol.20 (2), p.85-93 |
| issn | 1479-666X 2405-5840 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Anticoagulants - therapeutic use Autologous vein Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation Case-Control Studies Chronic Limb-Threatening Ischemia Coated Materials, Biocompatible Comparison Critical limb ischemia Heparin Heparin bonded ePTFE Humans Infrainguinal bypass Ischemia - surgery Limb Salvage Polytetrafluoroethylene Propensity Score Prosthesis Design Retrospective Studies Saphenous Vein - surgery Saphenous Vein - transplantation Treatment Outcome Vascular Patency |
| title | Autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene as graft materials for below-the-knee femoro-popliteal bypass in patients with critical limb ischemia: A propensity score-matched analysis |
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