1015_Kum.pdf

1、BEST CLI and BASIL-2What have I Learned?Steven Kum MBBS MMed FRCS FAMS CWSPVascular SurgeonMount Elizabeth Novena Hospital/Changi General HospitalSingaporeDisclosureDisclosureWithin the past 12 months,I or my spouse/partner have had a financial interest/arrangement or affiliation with the organizati

2、on(s)listed below.Affiliation/Financial RelationshipCompany Research Support Boston Scientific,LimFlow/Inari Consulting Fees/Honoraria LimFlow/Inari,Acelity,Abbott Vascular,Boston Scientific,Orbus Neich,Bypass Solutions,PEDRA,Xeltis,Cagent Vascular Advisory Board Abbott,Boston Scientific,Xeltis,LimF

3、low/Inari,Fastwave,Corflow,VCD,Bypass Solutions,Protexa Equity LimFlow/Inari,Mercator,Cagent,PEDRA,Xeltis,Fastwave,Corflow,VCD,Bypass Solutions,Protexa,R3As a Vascular surgeon who trained in Open Surgery but ended up doing Endo,I have been conflicted all my life!Cohort 1Cohort 2The results from larg

4、e-scale RCTs;BEST CLI and BASIL-2Farber A,et al.N Engl J Med.2022;387:2305-2316Bradbury AW,et al.Lancet.2023:S0140-6736(23)00462-2Average AgeBEST-CLI:67y BASIL-2:72yEndpointsBEST-CLI:MALE(incl conversion bypass)and all mortalityBASIL-2:AFSWho perform the procedure?BEST-CLI:75%Vascular SurgeonsBASIL-

5、2:84%Interventional Radiologists(IR)ConclusionsBEST-CLI:Bypass Fewer major amputations&reinterventions than EVT,BASIL-2:EVT lower AFSCourtesy IidaBEST CLI-Results Surgical bypass was associated with a 32%reduction in MALE or all cause death,with a hazard ratio of 0.68 Driven by significantly more fi

6、rst major re-interventions in the EVT arm,and a significant 27%reduction in above ankle amputations in the surgery arm EVT arm experienced more than twice the total number of major re-interventions over period of follow up No difference in periprocedural death or major cardiovascular events at 30 da