Objective
to determine whether endovascular revascularisation is superior to surgical revascularization in patients with chronic limb-threatening ischemia (CLTI)
Study
prospective, open-label, multicentre, randomised, superiority trial
Population
patients with CLTI. Cohort 1: patients with single segment of great saphenous vein that could be used for surgery. Cohort 2: patients who needed an alternative bypass conduit. All patients judged to be suitable for both treatments
Endpoints
composite of major adverse limb event (i.e amputation above the ankle or major limb reintervention) or death from any cause
Conclusion
in patients with CLTI in cohort 1 incidence of a major adverse limb event or death was significantly lower with surgery compared to endovascular treatment. Among patients in cohort 2 the outcomes in the two groups were not statistically different
Farber et al. N.Engl.J. Med 2022; 387:2305-16
