1. Major amputation and all-cause mortality were higher in the vein bypass group compared to the best endovascular treatment group.
2. Cardiovascular and respiratory-related events contributed to most morbidity and mortality cases.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Chronic limb ischemia is the most severe form of peripheral arterial disease which often requires invasive interventions such as angioplasty, bypass grafting, and amputation. Despite successful revascularization, patients with chronic limb ischemia require multiple procedures and frequent hospital readmissions. This randomized controlled trial aimed to compare the safety and efficacy of vein bypass with the best endovascular treatment in patients with chronic limb-threatening ischemia. The primary outcome was amputation-free survival and death while key secondary outcomes included time to major amputation or revascularization. According to study results, best endovascular treatment was associated with better amputation-free survival compared to the vein bypass strategy. Although this study was well-done, it was largely skewed toward male patients who are known to have fewer complications of limb ischemia compared to female patients.
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