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Purpose: We evaluated the clinical outcomes of aortofemoral bypass (AoFB) and axillofemoral bypass (AxFB) surgeries for complex aortoiliac occlusive disease (AIOD) and compared them from the perspectives of safety and efficacy.
Methods: We retrospectively reviewed 21 patients with AoFB grafting and 9 patients with AxFB grafting. The demographic information of the patients was examined, and the intra-, peri-, and postoperative results as well as long-term outcomes were evaluated.
Results: In the AoFB, 2 of 21 (9.5%) cases had intra- and perioperative complications, and 4 of 21 (19.0%) cases had postoperative complications; however, there were no postoperative mortalities. In the AxFB, two of nine (22.2%) cases had postoperative graft thrombosis; however, again there were no postoperative mortalities. According to Kaplan-Meier analysis, the primary patency rates in the AoFB and AxFB groups at 5 years were 94.8% and 53.6%, respectively (P = 0.001), while the limb salvage rates at 5 years were 96.4% and 92.9%, respectively (P = 0.320).
Conclusions: Even though the patency rates with AxFB grafting were inferior to those with AoFB grafting, AxFB was able to achieve equivalent limb salvage rates and should thus be considered as an alternative treatment method, especially when limb salvage is a goal.
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http://dx.doi.org/10.5761/atcs.oa.19-00300 | DOI Listing |
Circulation
September 2025
Division of Cardiology, Columbia University Irving Medical Center, New York, NY (S.A.P.).
Background: Limited treatment options exist for infrapopliteal disease in patients with chronic limb-threatening ischemia (CLTI), a condition associated with a high risk of limb loss. Interventional management of diseased infrapopliteal vessels with percutaneous transluminal angioplasty (PTA) is associated with high rates of restenosis and reintervention. In the LIFE-BTK trial, the drug-eluting resorbable scaffold (DRS) demonstrated superior 12-month efficacy compared with PTA in a selected CLTI population with predominantly noncomplex, mildly to moderately calcified lesions.
View Article and Find Full Text PDFSemin Vasc Surg
September 2025
Division of Vascular and Endovascular Surgery, Department of Surgery, Northwell Health, Manhasset, NY; Zucker School of Medicine at Hofstra, Hempstead, NY. Electronic address:
Peripheral arterial disease (PAD) is a prevalent and debilitating condition in elderly patients, often leading to critical limb threatening ischemia (CLTI) and major amputations. While endovascular interventions are usually preferred for their lower perioperative risk, open surgical revascularization should also be considered due to its durability and superior patency in complex disease patterns. Age alone does not determine suitability for surgery; rather, candidacy hinges on frailty, functional status, comorbidities, and anatomical considerations.
View Article and Find Full Text PDFSemin Vasc Surg
September 2025
Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, 4940 Eastern Ave, A549, Baltimore, MD, 21224. Electronic address:
As the world's elderly population continues to grow, the proportion of people living with chronic medical conditions is also increasing. Cardiovascular diseases including hypertension, diabetes, and atherosclerosis are among the most common, and as a result peripheral artery disease (PAD) is increasingly prevalent in this population. It is estimated that 15% to 20% of the elderly population has been diagnosed with PAD, and consequentially there is also a large proportion who have progressed to chronic limb threatening ischemia (CLTI).
View Article and Find Full Text PDFJACC Case Rep
September 2025
University Hospitals Harrington Heart & Vascular Institute, Cleveland, Ohio, USA. Electronic address:
Background: Up to 20% of patients with chronic limb-threatening ischemia (CLTI) are not eligible for conventional revascularization options despite having severe symptoms of nonhealing ulcers and gangrene. Transcatheter arterialization of the deep veins (TADV) has shown promising results in this challenging subset of patients.
Case Summary: We present the long-term outcomes of 4 patients with no-option CLTI who were at risk of major below-the-knee amputation and were treated with TADV with the LimFlow System (Inari Medical).
Cureus
August 2025
Orthopedics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND.
Giant cell tumor (GCT) of the bone, although benign, demonstrates local aggressiveness, a potential for recurrence, and, in rare instances, malignant transformation. Functional preservation is crucial in cases involving the articular surface, often utilizing the Sandwich Technique. We propose an enhanced reconstruction method using the inner table of the iliac crest in a reverse fashion, offering a more anatomically contoured proximal tibial plateau and reducing donor site morbidity compared to tricortical iliac crest grafting.
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