title: Limb salvage in patients with peripheral arterial disease managed by endovascular first approach.
abstract: This study aims to review the outcome of patients with peripheral arterial disease (PAD) managed with endovascular first approach for revascularization in a tertiary referral center. Revascularization procedures were performed in 202 patients with 229 symptomatic limbs. Angiogram was performed in all patients except those contraindicated for contrast agent. Angioplasty revascularization was carried out on the same setting whenever feasible based on the angiogram findings. Bypass surgery was performed in patients with arterial condition not feasible for endovascular intervention or in those with unsatisfactory revascularization after endovascular treatment. Endovascular intervention was successfully performed in 198 limbs. Bypass surgery was required in 31 patients. Another 16 patients required a bypass after endovascular intervention due to unsatisfactory wound healing. The Kaplan-Meier estimated survival and amputation-free survival were 80% and 75.5% at 1 year and 73% and 57.6% at 2 years, respectively. Satisfactory limb salvage rate can be achieved in patients with PAD managed with endovascular first approach.
authors.affiliation: 1Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Kyin Kyin
authors.initials: KK
authors.lastname: May
authors.forename: Peter Ashley
authors.initials: PA
authors.lastname: Robless
authors.forename: Harvinder Raj Singh
authors.initials: HR
authors.lastname: Sidhu
authors.forename: Ben Soo Yeng
authors.initials: BS
authors.lastname: Chua
authors.forename: Pei
authors.initials: P
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D017130:Angioplasty / Q000009:adverse effects / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D012086:Reoperation; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D014945:Wound Healing
keywords: claudication; critical limb ischemia; endovascular intervention; limb salvage; peripheral arterial disease