[Comparable results with percutaneous transluminal angioplasty and surgical bypass for critical ischaemia of the leg].
In patients with critical limb ischaemia resulting from arterial occlusion, both percutaneous recanalisation and bypass surgery are potential therapeutic options to avoid amputation. The recently published Bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial is the first randomised study to compare these techniques. The data from this trial show that patients eligible for balloon angioplasty or infra-inguinal bypass surgery fare equally well with percutaneous intervention. In the Netherlands, expertise with percutaneous intervention varies among hospitals. Consequently, the preferred strategy depends on the capabilities of the local hospital. Ideally, patients should be treated in hospitals with expertise in both techniques, because there is a trend towards fewer complications with percutaneous intervention. Moreover, there is a considerable difference in costs during the first year in favour of percutaneous intervention, mainly as a result of a shorter hospital stay.
Legemate
D A
DA
Academisch Medisch Centrum/Universiteit van Amsterdam. d.a.legemate@amc.nl
Reekers
J A
JA
D000800:Angioplasty, Balloon / Q000191:economics / Q000379:methods*; D017048:Health Care Costs; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D007902:Length of Stay; D009426:Netherlands; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000191:economics / Q000379:methods*