Validity of the Global Vascular Guidelines in Predicting Outcomes Based on First-Time Revascularization Strategy
The Global Vascular Guidelines (GVG) recommend selecting an endovascular versus open-surgical approach to revascularization for chronic limb-threatening ischemia (CLTI), based on the Global Limb Anatomic Staging System (GLASS) and wound, ischemia, and foot infection (WIfI) classification systems. We...
Gespeichert in:
| Veröffentlicht in: | Annals of vascular surgery 2023-09, Vol.95, p.142-153 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 153 |
|---|---|
| container_issue | |
| container_start_page | 142 |
| container_title | Annals of vascular surgery |
| container_volume | 95 |
| creator | Lou, Vivian Dossabhoy, Shernaz S. Tran, Kenneth Yawary, Farishta Ross, Elsie G. Stern, Jordan R. Dalman, Ronald L. Chandra, Venita |
| description | The Global Vascular Guidelines (GVG) recommend selecting an endovascular versus open-surgical approach to revascularization for chronic limb-threatening ischemia (CLTI), based on the Global Limb Anatomic Staging System (GLASS) and wound, ischemia, and foot infection (WIfI) classification systems. We assessed the utility of GVG-recommended strategies in predicting clinical outcomes.
We conducted a single-center, retrospective review of first-time lower-extremity revascularizations within a comprehensive limb-preservation program from 2010 to 2018. Procedures were stratified by (1) treatment concordance with GVG-recommended strategy (concordant versus nonconcordant groups), (2) GLASS stages I-III, and (3) endovascular versus open strategies. The primary outcome was 5-year freedom from major adverse limb events (FF-MALE), defined as freedom from reintervention or major amputation, and secondary outcomes included 5-year overall survival, freedom from major amputation, freedom from reintervention, and immediate technical failure (ITF) during initial revascularization. Kaplan-Meier (KM) survival analysis and multivariate analysis with Cox proportional hazard models were performed on the primary and secondary outcomes.
Of 281 first-time revascularizations for CLTI, 251 (89.3%) were endovascular and 186 (66.2%) were in the concordant group, with a mean clinical follow-up of 3.02 ± 2.40 years. Within the concordant group alone, 167 (89.8%) of revascularizations were endovascular. The concordant group had a higher rate of chronic kidney disease (60.8% vs. 45.3%, P = 0.02), WIfI foot infection grade (0.81 ± 1.1 vs. 0.56 ± 0.80, P = 0.03), and WIfI stage (3.1 ± 0.79 vs. 2.8 ± 1.2, P |
| doi_str_mv | 10.1016/j.avsg.2023.02.001 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2780075958</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S089050962300095X</els_id><sourcerecordid>2780075958</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-285aca7539c43e92e7dbead5538f6fd099cee131ba36296aee081d47df3b69443</originalsourceid><addsrcrecordid>eNp9kE1vEzEQhi0EomnpH-CAfOSyiz_WXlviAhUNSJWKoO3V8tqzwdF-BNsbKfz6OkrgyGmkmed9pXkQektJTQmVH7a13adNzQjjNWE1IfQFWlFJRSV0075EK6I0qQTR8gJdprQtAFONeo0uuFRMUS5WaPdkh-BDPuC5x_kX4PUwd3bATza5ZbARr5fgYQgTJBwm_D2CDy6HaYPvl-zmsaw_2wQezxO-DTHl6iGMgH_A_lwQ_tgcyvFnjjbD5vAGvertkOD6PK_Q4-2Xh5uv1d39-tvNp7vKcSFzxZSwzraCa9dw0Axa34H1QnDVy94TrR0A5bSzXDItLQBR1Det73knddPwK_T-1LuL8-8FUjZjSA6GwU4wL8mwVhHSCi1UQdkJdXFOKUJvdjGMNh4MJeZo2mzN0bQ5mjaEmSKyhN6d-5duBP8v8ldtAT6eAChf7gNEk1yAyRWBEVw2fg7_638G-b6RDA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2780075958</pqid></control><display><type>article</type><title>Validity of the Global Vascular Guidelines in Predicting Outcomes Based on First-Time Revascularization Strategy</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Lou, Vivian ; Dossabhoy, Shernaz S. ; Tran, Kenneth ; Yawary, Farishta ; Ross, Elsie G. ; Stern, Jordan R. ; Dalman, Ronald L. ; Chandra, Venita</creator><creatorcontrib>Lou, Vivian ; Dossabhoy, Shernaz S. ; Tran, Kenneth ; Yawary, Farishta ; Ross, Elsie G. ; Stern, Jordan R. ; Dalman, Ronald L. ; Chandra, Venita</creatorcontrib><description>The Global Vascular Guidelines (GVG) recommend selecting an endovascular versus open-surgical approach to revascularization for chronic limb-threatening ischemia (CLTI), based on the Global Limb Anatomic Staging System (GLASS) and wound, ischemia, and foot infection (WIfI) classification systems. We assessed the utility of GVG-recommended strategies in predicting clinical outcomes.
We conducted a single-center, retrospective review of first-time lower-extremity revascularizations within a comprehensive limb-preservation program from 2010 to 2018. Procedures were stratified by (1) treatment concordance with GVG-recommended strategy (concordant versus nonconcordant groups), (2) GLASS stages I-III, and (3) endovascular versus open strategies. The primary outcome was 5-year freedom from major adverse limb events (FF-MALE), defined as freedom from reintervention or major amputation, and secondary outcomes included 5-year overall survival, freedom from major amputation, freedom from reintervention, and immediate technical failure (ITF) during initial revascularization. Kaplan-Meier (KM) survival analysis and multivariate analysis with Cox proportional hazard models were performed on the primary and secondary outcomes.
Of 281 first-time revascularizations for CLTI, 251 (89.3%) were endovascular and 186 (66.2%) were in the concordant group, with a mean clinical follow-up of 3.02 ± 2.40 years. Within the concordant group alone, 167 (89.8%) of revascularizations were endovascular. The concordant group had a higher rate of chronic kidney disease (60.8% vs. 45.3%, P = 0.02), WIfI foot infection grade (0.81 ± 1.1 vs. 0.56 ± 0.80, P = 0.03), and WIfI stage (3.1 ± 0.79 vs. 2.8 ± 1.2, P < 0.01) compared to the non-concordant group. After both KM and multivariate analyses, there were no significant differences in 5-year FF-MALE or overall survival between concordant and non-concordant groups. There was higher freedom from major amputation in the non-concordant group on KM analysis (83.9% vs. 74.2%, P = 0.025), though this difference was non-significant on multivariate analysis (hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.21–1.15, P = 0.10). The open group had lower MALE compared to the endovascular group (HR: 0.39, 95% CI: 0.17–0.91, P = 0.029) attributed to a lower reintervention rate in the open group (HR: 0.31, 95% CI: 0.11–0.87, P = 0.026). GLASS stage was not associated with significant differences in outcomes, but the severity of GLASS stage was associated with ITF (2.1% in stage 1, 6.4% in stage 2, and 11.7% in stage 3, P = 0.01).
In this study, CLTI treatment outcomes did not differ significantly based on whether treatment was received in concordance with GVG-recommended strategy. There was no difference in overall survival between the endovascular and open groups, though there was a higher reintervention rate in the endovascular group. The GVG guidelines are an important resource to help guide the management of CLTI patients. However, in this study, both concordance with GVG guidelines and GLASS staging were found to be indeterminate in differentiating outcomes between complex CLTI patients treated primarily with an endovascular-first approach. The revascularization approach for a CLTI patient is a nuanced decision that must take into account patient anatomy and clinical status, as well as physician skill and experience and institutional resources.
•In 281 first-time revascularizations for chronic limb-threatening ischemia, whether treatment was concordant or nonconcordant with the Global Vascular Guidelines (GVG) recommended revascularization strategy (endovascular versus open) had no significant effect on freedom from 5-year major adverse limb events (45.3% vs. 50.7%) or overall survival (47.9% vs. 50.6%).•Treatment outcomes for chronic limb-threatening ischemia did not differ significantly based on whether treatment was received in concordance with GVG recommended strategy.•Further evaluation of GVG and optimal revascularization approach is required.</description><identifier>ISSN: 0890-5096</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1016/j.avsg.2023.02.001</identifier><identifier>PMID: 36828135</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Chronic Disease ; Chronic Limb-Threatening Ischemia ; Endovascular Procedures ; Humans ; Ischemia - diagnostic imaging ; Ischemia - surgery ; Limb Salvage - adverse effects ; Peripheral Arterial Disease - diagnostic imaging ; Peripheral Arterial Disease - surgery ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>Annals of vascular surgery, 2023-09, Vol.95, p.142-153</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-285aca7539c43e92e7dbead5538f6fd099cee131ba36296aee081d47df3b69443</citedby><cites>FETCH-LOGICAL-c356t-285aca7539c43e92e7dbead5538f6fd099cee131ba36296aee081d47df3b69443</cites><orcidid>0000-0001-5047-3605</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.avsg.2023.02.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36828135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lou, Vivian</creatorcontrib><creatorcontrib>Dossabhoy, Shernaz S.</creatorcontrib><creatorcontrib>Tran, Kenneth</creatorcontrib><creatorcontrib>Yawary, Farishta</creatorcontrib><creatorcontrib>Ross, Elsie G.</creatorcontrib><creatorcontrib>Stern, Jordan R.</creatorcontrib><creatorcontrib>Dalman, Ronald L.</creatorcontrib><creatorcontrib>Chandra, Venita</creatorcontrib><title>Validity of the Global Vascular Guidelines in Predicting Outcomes Based on First-Time Revascularization Strategy</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>The Global Vascular Guidelines (GVG) recommend selecting an endovascular versus open-surgical approach to revascularization for chronic limb-threatening ischemia (CLTI), based on the Global Limb Anatomic Staging System (GLASS) and wound, ischemia, and foot infection (WIfI) classification systems. We assessed the utility of GVG-recommended strategies in predicting clinical outcomes.
We conducted a single-center, retrospective review of first-time lower-extremity revascularizations within a comprehensive limb-preservation program from 2010 to 2018. Procedures were stratified by (1) treatment concordance with GVG-recommended strategy (concordant versus nonconcordant groups), (2) GLASS stages I-III, and (3) endovascular versus open strategies. The primary outcome was 5-year freedom from major adverse limb events (FF-MALE), defined as freedom from reintervention or major amputation, and secondary outcomes included 5-year overall survival, freedom from major amputation, freedom from reintervention, and immediate technical failure (ITF) during initial revascularization. Kaplan-Meier (KM) survival analysis and multivariate analysis with Cox proportional hazard models were performed on the primary and secondary outcomes.
Of 281 first-time revascularizations for CLTI, 251 (89.3%) were endovascular and 186 (66.2%) were in the concordant group, with a mean clinical follow-up of 3.02 ± 2.40 years. Within the concordant group alone, 167 (89.8%) of revascularizations were endovascular. The concordant group had a higher rate of chronic kidney disease (60.8% vs. 45.3%, P = 0.02), WIfI foot infection grade (0.81 ± 1.1 vs. 0.56 ± 0.80, P = 0.03), and WIfI stage (3.1 ± 0.79 vs. 2.8 ± 1.2, P < 0.01) compared to the non-concordant group. After both KM and multivariate analyses, there were no significant differences in 5-year FF-MALE or overall survival between concordant and non-concordant groups. There was higher freedom from major amputation in the non-concordant group on KM analysis (83.9% vs. 74.2%, P = 0.025), though this difference was non-significant on multivariate analysis (hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.21–1.15, P = 0.10). The open group had lower MALE compared to the endovascular group (HR: 0.39, 95% CI: 0.17–0.91, P = 0.029) attributed to a lower reintervention rate in the open group (HR: 0.31, 95% CI: 0.11–0.87, P = 0.026). GLASS stage was not associated with significant differences in outcomes, but the severity of GLASS stage was associated with ITF (2.1% in stage 1, 6.4% in stage 2, and 11.7% in stage 3, P = 0.01).
In this study, CLTI treatment outcomes did not differ significantly based on whether treatment was received in concordance with GVG-recommended strategy. There was no difference in overall survival between the endovascular and open groups, though there was a higher reintervention rate in the endovascular group. The GVG guidelines are an important resource to help guide the management of CLTI patients. However, in this study, both concordance with GVG guidelines and GLASS staging were found to be indeterminate in differentiating outcomes between complex CLTI patients treated primarily with an endovascular-first approach. The revascularization approach for a CLTI patient is a nuanced decision that must take into account patient anatomy and clinical status, as well as physician skill and experience and institutional resources.
•In 281 first-time revascularizations for chronic limb-threatening ischemia, whether treatment was concordant or nonconcordant with the Global Vascular Guidelines (GVG) recommended revascularization strategy (endovascular versus open) had no significant effect on freedom from 5-year major adverse limb events (45.3% vs. 50.7%) or overall survival (47.9% vs. 50.6%).•Treatment outcomes for chronic limb-threatening ischemia did not differ significantly based on whether treatment was received in concordance with GVG recommended strategy.•Further evaluation of GVG and optimal revascularization approach is required.</description><subject>Chronic Disease</subject><subject>Chronic Limb-Threatening Ischemia</subject><subject>Endovascular Procedures</subject><subject>Humans</subject><subject>Ischemia - diagnostic imaging</subject><subject>Ischemia - surgery</subject><subject>Limb Salvage - adverse effects</subject><subject>Peripheral Arterial Disease - diagnostic imaging</subject><subject>Peripheral Arterial Disease - surgery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0890-5096</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1vEzEQhi0EomnpH-CAfOSyiz_WXlviAhUNSJWKoO3V8tqzwdF-BNsbKfz6OkrgyGmkmed9pXkQektJTQmVH7a13adNzQjjNWE1IfQFWlFJRSV0075EK6I0qQTR8gJdprQtAFONeo0uuFRMUS5WaPdkh-BDPuC5x_kX4PUwd3bATza5ZbARr5fgYQgTJBwm_D2CDy6HaYPvl-zmsaw_2wQezxO-DTHl6iGMgH_A_lwQ_tgcyvFnjjbD5vAGvertkOD6PK_Q4-2Xh5uv1d39-tvNp7vKcSFzxZSwzraCa9dw0Axa34H1QnDVy94TrR0A5bSzXDItLQBR1Det73knddPwK_T-1LuL8-8FUjZjSA6GwU4wL8mwVhHSCi1UQdkJdXFOKUJvdjGMNh4MJeZo2mzN0bQ5mjaEmSKyhN6d-5duBP8v8ldtAT6eAChf7gNEk1yAyRWBEVw2fg7_638G-b6RDA</recordid><startdate>202309</startdate><enddate>202309</enddate><creator>Lou, Vivian</creator><creator>Dossabhoy, Shernaz S.</creator><creator>Tran, Kenneth</creator><creator>Yawary, Farishta</creator><creator>Ross, Elsie G.</creator><creator>Stern, Jordan R.</creator><creator>Dalman, Ronald L.</creator><creator>Chandra, Venita</creator><general>Elsevier Inc</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/0000-0001-5047-3605</orcidid></search><sort><creationdate>202309</creationdate><title>Validity of the Global Vascular Guidelines in Predicting Outcomes Based on First-Time Revascularization Strategy</title><author>Lou, Vivian ; Dossabhoy, Shernaz S. ; Tran, Kenneth ; Yawary, Farishta ; Ross, Elsie G. ; Stern, Jordan R. ; Dalman, Ronald L. ; Chandra, Venita</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-285aca7539c43e92e7dbead5538f6fd099cee131ba36296aee081d47df3b69443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Chronic Disease</topic><topic>Chronic Limb-Threatening Ischemia</topic><topic>Endovascular Procedures</topic><topic>Humans</topic><topic>Ischemia - diagnostic imaging</topic><topic>Ischemia - surgery</topic><topic>Limb Salvage - adverse effects</topic><topic>Peripheral Arterial Disease - diagnostic imaging</topic><topic>Peripheral Arterial Disease - surgery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lou, Vivian</creatorcontrib><creatorcontrib>Dossabhoy, Shernaz S.</creatorcontrib><creatorcontrib>Tran, Kenneth</creatorcontrib><creatorcontrib>Yawary, Farishta</creatorcontrib><creatorcontrib>Ross, Elsie G.</creatorcontrib><creatorcontrib>Stern, Jordan R.</creatorcontrib><creatorcontrib>Dalman, Ronald L.</creatorcontrib><creatorcontrib>Chandra, Venita</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>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lou, Vivian</au><au>Dossabhoy, Shernaz S.</au><au>Tran, Kenneth</au><au>Yawary, Farishta</au><au>Ross, Elsie G.</au><au>Stern, Jordan R.</au><au>Dalman, Ronald L.</au><au>Chandra, Venita</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validity of the Global Vascular Guidelines in Predicting Outcomes Based on First-Time Revascularization Strategy</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>2023-09</date><risdate>2023</risdate><volume>95</volume><spage>142</spage><epage>153</epage><pages>142-153</pages><issn>0890-5096</issn><eissn>1615-5947</eissn><abstract>The Global Vascular Guidelines (GVG) recommend selecting an endovascular versus open-surgical approach to revascularization for chronic limb-threatening ischemia (CLTI), based on the Global Limb Anatomic Staging System (GLASS) and wound, ischemia, and foot infection (WIfI) classification systems. We assessed the utility of GVG-recommended strategies in predicting clinical outcomes.
We conducted a single-center, retrospective review of first-time lower-extremity revascularizations within a comprehensive limb-preservation program from 2010 to 2018. Procedures were stratified by (1) treatment concordance with GVG-recommended strategy (concordant versus nonconcordant groups), (2) GLASS stages I-III, and (3) endovascular versus open strategies. The primary outcome was 5-year freedom from major adverse limb events (FF-MALE), defined as freedom from reintervention or major amputation, and secondary outcomes included 5-year overall survival, freedom from major amputation, freedom from reintervention, and immediate technical failure (ITF) during initial revascularization. Kaplan-Meier (KM) survival analysis and multivariate analysis with Cox proportional hazard models were performed on the primary and secondary outcomes.
Of 281 first-time revascularizations for CLTI, 251 (89.3%) were endovascular and 186 (66.2%) were in the concordant group, with a mean clinical follow-up of 3.02 ± 2.40 years. Within the concordant group alone, 167 (89.8%) of revascularizations were endovascular. The concordant group had a higher rate of chronic kidney disease (60.8% vs. 45.3%, P = 0.02), WIfI foot infection grade (0.81 ± 1.1 vs. 0.56 ± 0.80, P = 0.03), and WIfI stage (3.1 ± 0.79 vs. 2.8 ± 1.2, P < 0.01) compared to the non-concordant group. After both KM and multivariate analyses, there were no significant differences in 5-year FF-MALE or overall survival between concordant and non-concordant groups. There was higher freedom from major amputation in the non-concordant group on KM analysis (83.9% vs. 74.2%, P = 0.025), though this difference was non-significant on multivariate analysis (hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.21–1.15, P = 0.10). The open group had lower MALE compared to the endovascular group (HR: 0.39, 95% CI: 0.17–0.91, P = 0.029) attributed to a lower reintervention rate in the open group (HR: 0.31, 95% CI: 0.11–0.87, P = 0.026). GLASS stage was not associated with significant differences in outcomes, but the severity of GLASS stage was associated with ITF (2.1% in stage 1, 6.4% in stage 2, and 11.7% in stage 3, P = 0.01).
In this study, CLTI treatment outcomes did not differ significantly based on whether treatment was received in concordance with GVG-recommended strategy. There was no difference in overall survival between the endovascular and open groups, though there was a higher reintervention rate in the endovascular group. The GVG guidelines are an important resource to help guide the management of CLTI patients. However, in this study, both concordance with GVG guidelines and GLASS staging were found to be indeterminate in differentiating outcomes between complex CLTI patients treated primarily with an endovascular-first approach. The revascularization approach for a CLTI patient is a nuanced decision that must take into account patient anatomy and clinical status, as well as physician skill and experience and institutional resources.
•In 281 first-time revascularizations for chronic limb-threatening ischemia, whether treatment was concordant or nonconcordant with the Global Vascular Guidelines (GVG) recommended revascularization strategy (endovascular versus open) had no significant effect on freedom from 5-year major adverse limb events (45.3% vs. 50.7%) or overall survival (47.9% vs. 50.6%).•Treatment outcomes for chronic limb-threatening ischemia did not differ significantly based on whether treatment was received in concordance with GVG recommended strategy.•Further evaluation of GVG and optimal revascularization approach is required.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>36828135</pmid><doi>10.1016/j.avsg.2023.02.001</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-5047-3605</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0890-5096 |
| ispartof | Annals of vascular surgery, 2023-09, Vol.95, p.142-153 |
| issn | 0890-5096 1615-5947 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2780075958 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Chronic Disease Chronic Limb-Threatening Ischemia Endovascular Procedures Humans Ischemia - diagnostic imaging Ischemia - surgery Limb Salvage - adverse effects Peripheral Arterial Disease - diagnostic imaging Peripheral Arterial Disease - surgery Retrospective Studies Risk Factors Time Factors Treatment Outcome |
| title | Validity of the Global Vascular Guidelines in Predicting Outcomes Based on First-Time Revascularization Strategy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T11%3A49%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Validity%20of%20the%20Global%20Vascular%20Guidelines%20in%20Predicting%20Outcomes%20Based%20on%20First-Time%20Revascularization%20Strategy&rft.jtitle=Annals%20of%20vascular%20surgery&rft.au=Lou,%20Vivian&rft.date=2023-09&rft.volume=95&rft.spage=142&rft.epage=153&rft.pages=142-153&rft.issn=0890-5096&rft.eissn=1615-5947&rft_id=info:doi/10.1016/j.avsg.2023.02.001&rft_dat=%3Cproquest_cross%3E2780075958%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2780075958&rft_id=info:pmid/36828135&rft_els_id=S089050962300095X&rfr_iscdi=true |