This study states that Physician-oriented outcomes, such as patency and amputation-free survival (AFS), have traditionally been markers of success after lower extremity revascularization. Previous studies have defined clinical success on the basis of a composite of patient-centered outcomes and have shown this outcome to be achieved in <50% of patients. The purpose of this study was to evaluate clinical success after lower extremity bypass (LEB) or peripheral vascular intervention (PVI) for tissue loss in diabetic patients in a multidisciplinary setting.
All patients presenting to our multidisciplinary diabetic limb preservation service from July 2012 to May 2019 were enrolled in a prospective database. Patients who underwent either LEB or PVI for ulcer or gangrene were included in the analysis. Clinical success was defined as the composite outcome of secondary patency to the point of wound healing, limb salvage for 1 year, maintenance of ambulatory status for 1 year, and survival for 6 months. Secondary outcomes included 1-year wound healing, secondary patency, and AFS. Among diabetic patients presenting with tissue loss, the composite outcome of patient-oriented clinical success is lower than traditional physician-centered outcomes after lower extremity revascularization, mostly because of low rates of secondary patency to the point of wound healing. Clinical success in our study was still better than that reported in previous studies, which may be related to low median wound healing times associated with our multidisciplinary approach.
Reference link-https://www.jvascsurg.org/article/S0741-5214(20)31991-1/fulltext
