1045_Goueffic.pdf

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1、When Do I Choose Bypass vs.Endo in BTK Disease?Y.Gouffic,MD,PhDDepartment of vascular and endovascular surgery,Groupe Hospitalier Paris Saint Joseph,Paris,France.Y.Gouffic reports:Research funding from Abbott,Bentley,General Electric,Sensome,WL GorePersonal fees and grants from Abbott,BD,Bentley,Bio

2、tronik,Boston Scientific,Cook,General Electric,Medtronic,Penumbra,Shockwave,WL Gore(medical advisory board,educational course,speaking)Disclosures2018-2022:230,256 Patients Underwent Infra-inguinal Revascularization in FranceGouffic,SCVE,2025Evidence Based Revascularization Comparing Endo/openFlawed

3、 studies-Few randomized controlled studies-Small numbers,single center,single operator-Poorly defined patient demographics and interventions-Intermittent claudication and CLTI combined-Suprainguinal and infrainguinal disease combined-Short or incomplete follow-up,or both-Retrospective analysisMain R

4、CTs-Bypass versus Angioplasty for Severe Ischemia of the Leg(BASIL)1,2 and(3).-Best Endovascular Versus Best Surgical Therapy in Patients With CLTI(BEST-CLI)Farber,NEJM,2022;Adam,Lancet,2005;Bradbury,Lancet,2023;Bradbury,BMJ,2025BASIL 1 RCTBypass vs Angioplasty in Severe Ischaemia of the Leg(BASIL)t

5、rial-Compared an endovascular-first with a bypass surgery-first strategyin limb-threatening ischemia due to infrainguinal disease.-27 hospitals in the United Kingdom and enrolled 452 participants between 1999 and 2004.-Primary endpoint:amputation free survival-Secondary endpoints:all causes mortalit

6、y,perioperative mortality,quality of life and cost effectivenessAdam,Lancet,2005BASIL 1 RCT Primary OutcomesBypass vs Angioplasty in Severe Ischaemia of the Leg(BASIL)trialAn intention-to-treat analysis showed no significantdifference between the two arms in terms of AFS and overallsurvival.A post-h