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Society for Vascular Surgery limb stage and patient risk correlate with outcomes in an amputation prevention program  Marlin W. Causey, MD, Ayman Ahmed,

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Presentation on theme: "Society for Vascular Surgery limb stage and patient risk correlate with outcomes in an amputation prevention program  Marlin W. Causey, MD, Ayman Ahmed,"— Presentation transcript:

1 Society for Vascular Surgery limb stage and patient risk correlate with outcomes in an amputation prevention program  Marlin W. Causey, MD, Ayman Ahmed, MD, Bian Wu, MD, Warren J. Gasper, MD, Alex Reyzelman, DPM, Shant M. Vartanian, MD, Jade S. Hiramoto, MD, Michael S. Conte, MD  Journal of Vascular Surgery  Volume 63, Issue 6, Pages e2 (June 2016) DOI: /j.jvs Copyright © 2016 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Distribution of limbs stratified in bivariate fashion by Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) limb risk and Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) patient risk. As WIfI stage increases, the proportion with moderate to high PIII risk increases (χ2, P < .001). Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Revascularization procedures within the study cohort. ∗Three patients underwent open procedures that were not bypass grafts (endarterectomy), and are not shown here. AIOD, Isolated aortoiliac occlusive disease; BTK, below the knee; FemPop, femoropopliteal segment. Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Kaplan-Meier analysis of key midterm limb-specific outcomes by Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) stage. A, Freedom from major adverse limb events (MALE). B, Freedom from major amputation. Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Kaplan-Meier analysis demonstrating overall patient-level survival by Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) patient risk stratification. Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

6 Fig 5 A, Major adverse limb events (MALE) outcome among subjects who underwent infrainguinal revascularization stratified by endovascular approach, autogenous venous conduit, and other conduit (P = .025). Three patients received surgical revascularization that did not require bypass and are not included in these comparisons. B, Outcomes by type of revascularization in limbs at highest risk, Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) stage 4 patients (n = 44), stratified by surgical vs endovascular revascularization (P = .026). Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

7 Supplementary Fig 1 (online only)
Kaplan-Meier analysis demonstrating patient-level amputation free survival by Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) patient risk stratification. Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

8 Supplementary Fig 2 (online only)
Freedom from major adverse limb events (MALE) after infrainguinal bypass, stratified by type of conduit. Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

9 Supplementary Fig 3 (online only)
Proposed clinical decision matrix based on a 3-dimensional scheme including patient risk (eg, Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) risk category), limb severity (eg, Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (wound extent, ischemia, and foot infection [WIfI]) stage) and anatomic pattern of disease in chronic limb threatening ischemia. Journal of Vascular Surgery  , e2DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

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