title: Comparative study of venous arterialization and pedal bypass in a patient cohort with critical limb ischemia.
abstract: OBJECTIVE
  Patients with critical limb ischemia (CLI) have a poor life expectancy, and aggressive revascularization is accepted as a means to maintain their independence in the end stage of life. The goal of this case-control study was to evaluate the clinical outcome of distal venous arterialization and compare this with pedal bypass surgery in patients with CLI, and to identify potential risk factors that could be used to effectively identify patients at high risk of graft occlusion and amputation.
  
  
  METHODS
  A retrospective cohort of patients was treated for CLI using venous arterialization or pedal bypass between 2007 and 2012. Kaplan-Meier and Cox regression analyses were used to evaluate predictors for limb salvage and patency.
  
  
  RESULTS
  In 40 patients with CLI, 21 venous arterializations and 19 pedal bypasses were performed. In the venous arterialization group, early occlusion was 15%, 1-year patency was 71%, and limb salvage was 53%. In the PB group, early occlusion was 23%, one-year patency was 75% and limb salvage was 47%. The only independent risk factor for limb salvage in multivariate analysis was bypass occlusion (P<0.001).
  
  
  CONCLUSIONS
  Limb salvage after venous arterialization was equal to limb salvage after pedal bypass surgery in this clinical comparative study.
authors.affiliation: Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. Electronic address: mschreve@hotmail.com.
authors.forename: Michiel A
authors.initials: MA
authors.lastname: Schreve
authors.affiliation: Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Minnee
authors.affiliation: Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Bosma
authors.affiliation: Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Vanessa J
authors.initials: VJ
authors.lastname: Leijdekkers
authors.affiliation: Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mirza M
authors.initials: MM
authors.lastname: Idu
authors.affiliation: Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Anco C
authors.initials: AC
authors.lastname: Vahl
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*