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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2015 ; 94
(34
): e1427
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English Wikipedia
Direct Revascularization With the Angiosome Concept for Lower Limb Ischemia: A
Systematic Review and Meta-Analysis
#MMPMID26313796
Huang TY
; Huang TS
; Wang YC
; Huang PF
; Yu HC
; Yeh CH
Medicine (Baltimore)
2015[Aug]; 94
(34
): e1427
PMID26313796
show ga
The angiosome concept provides practical information regarding the vascular
anatomy of reconstructive and vascular surgery for the treatment of peripheral
arterial occlusive disease and, particularly, critical lower limb ischemia.The
aim of the study was to confirm the efficacy of direct revascularization with the
angiosome concept (DR) for lower limb ischemia.Complementary manual searches were
performed through the Pubmed, Cochrane Library, and EMBASE databases.We searched
all randomized and nonrandomized studies (NRSs) comparing DR with indirect
revascularization (IR) (without the angiosome concept) for lower limb ischemia.
Only 9 nonrandomized controlled retrospective cohort studies were found and
included. Trials published in any language were included.Primary endpoints were
time to limb amputation and time to wound healing. Data extraction and trial
quality assessment were performed by two authors independently. A third author
was consulted for disagreements settlement and quality assurance.Five NRSs
involving 779 lower limbs revealed that DR significantly improved the overall
survival of limbs (hazard ratio [HR] 0.61; 95% confidence interval
[CI]?=?0.46-0.80; P?0.001; I?=?0%). In addition, DR significantly improved time
to wound healing (HR 1.38; 95% CI?=?1.13-1.69; P?=?0.002; I?=?0%, in 5 studies
including 605 limbs).All included studies were retrospective comparative studies,
and no consensus was obtained in describing wound conditions in the included
studies.Our results suggested that treatment of lower limb ischemia using DR is
more effective in salvaging limbs and healing wounds than IR is. Additional
randomized controlled studies are necessary to confirm these results.