OBJECTIVES: Analyze the influence of the collateral distal vessels on ischemic ulcer healing and limb salvage after successful distal procedures, according to an angiosome model. METHODS: Retrospective analysis of 76 ischemic ulcers revascularized by surgical (n = 41) and endovascular (n = 35) distal procedures. All interventions were primary procedures with single outflow vessel that remained patent during follow-up. Ulcers were classified according to an angiography angiosome study as ''direct revascularization'' ([DR] n = 45), ''indirect revascularization'' ([IR] n = 31), and IR ''through collaterals'' ([IRc] n = 18). Healing rates and limb salvage were compared according to the type of revascularization. RESULTS: Ulcer healing rate at 12 months was higher in DR than in IR (92% vs 73%, P = .008) but similar to IRc (92% vs 85%). Limb salvage at 24 months was higher in DR than in IR (93% vs 72%, P = .02) but similar to IRc (93% vs 88%). CONCLUSION: Ulcer blood flow restoration through collateral vessels may give similar results to those obtained through its specific source artery.
OBJECTIVES: Analyze the influence of the collateral distal vessels on ischemic ulcer healing and limb salvage after successful distal procedures, according to an angiosome model. METHODS: Retrospective analysis of 76 ischemic ulcers revascularized by surgical (n = 41) and endovascular (n = 35) distal procedures. All interventions were primary procedures with single outflow vessel that remained patent during follow-up. Ulcers were classified according to an angiography angiosome study as ''direct revascularization'' ([DR] n = 45), ''indirect revascularization'' ([IR] n = 31), and IR ''through collaterals'' ([IRc] n = 18). Healing rates and limb salvage were compared according to the type of revascularization. RESULTS:Ulcer healing rate at 12 months was higher in DR than in IR (92% vs 73%, P = .008) but similar to IRc (92% vs 85%). Limb salvage at 24 months was higher in DR than in IR (93% vs 72%, P = .02) but similar to IRc (93% vs 88%). CONCLUSION: Ulcer blood flow restoration through collateral vessels may give similar results to those obtained through its specific source artery.
Authors: Marie D Gerhard-Herman; Heather L Gornik; Coletta Barrett; Neal R Barshes; Matthew A Corriere; Douglas E Drachman; Lee A Fleisher; Francis Gerry R Fowkes; Naomi M Hamburg; Scott Kinlay; Robert Lookstein; Sanjay Misra; Leila Mureebe; Jeffrey W Olin; Rajan A G Patel; Judith G Regensteiner; Andres Schanzer; Mehdi H Shishehbor; Kerry J Stewart; Diane Treat-Jacobson; M Eileen Walsh Journal: Circulation Date: 2016-11-13 Impact factor: 29.690
Authors: Jeremy D Darling; John C McCallum; Peter A Soden; John J Hon; Raul J Guzman; Mark C Wyers; Hence J Verhagen; Marc L Schermerhorn Journal: J Vasc Surg Date: 2016-08-31 Impact factor: 4.268
Authors: Jeremy D Darling; Thomas F X O'Donnell; Giap H Vu; Anthony V Norman; Emily St John; Lars Stangenberg; Mark C Wyers; Allen D Hamdan; Marc L Schermerhorn Journal: J Vasc Surg Date: 2020-08-29 Impact factor: 4.268