Abstract:
Background. Chronic limb-threatening ischemia (CLTI)
treatment options, particularly endovascular and bypass
grafting methods, have been widely debated, with a focus
on successful outcomes and fewer complications. Objective
of the study. To compare the effectiveness of two surgical
options for treating CLTI concerning follow-up, quality of
life (QoL), hospital stay duration, and patient outcomes.
Material and methods. A search on PubMed for English
clinical trials published from 2014-2024 was conducted using the terms: “Chronic limb-threatening ischemia,” “Endovascular techniques,” “Bypass grafting,” “Allograft bypass,”
“Infrainguinal bypass.” Results. Six clinical trials comparing
bypass grafting and endovascular techniques for CLTI were
analyzed. Initially (months 1-3), bypass surgery requires
more follow-up visits to monitor healing and graft patency,
affecting daily activities and requiring a longer hospital stay
(7 days). This method results in fewer reinterventions and
lower long-term amputation rates but has higher perioperative risk, especially for high-risk patients. Endovascular
techniques allow faster recovery and improved QoL with
reduced initial surgical risk but have a higher chance of
restenosis, possibly necessitating repeat treatments and
increasing long-term amputation risk. Conclusion. Bypass
surgery may be preferred in severe cases with high amputation risk, while endovascular procedures are better suited
for high-risk surgical patients, offering faster recovery with
comparable long-term follow-up requirements.
