Evidence map›Paper›PMID 40177778›Full record

ArticleCirculation. Cardiovascular interventions2025

Age-Related Outcomes After Revascularization for Chronic Limb-Threatening Ischemia: An Analysis of BEST-CLI.

Khanjan B Shah, Hanaa Aridi, Michael D Dake, Gheorghe Doros, Alik Farber, Matthew T Menard, Raghu Motaganahalli, Cassius Ochoa Chaar, Kenneth Rosenfield, Salvatore T Scali and 4 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular interventions, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Khanjan B ShahDivision of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville (K.B.S.).ORCID 0000-0001-8244-8236
Hanaa AridiDivision of Vascular Surgery, Indiana University School of Medicine, Indianapolis (H.A., R.M.).ORCID 0000-0002-8245-3104
Michael D DakeDepartment of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.).ORCID 0000-0002-2817-0875
Gheorghe DorosDepartment of Biostatistics, Boston University, School of Public Health, MA (G.D.).
Alik FarberDivision of Vascular and Endovascular Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA (A.F.).ORCID 0000-0001-7231-4189
Matthew T MenardDivision of Vascular and Endovascular Surgery, Brigham and Women's Hospital (M.T.M., M.B.S.), Harvard Medical School, Boston.ORCID 0000-0003-2470-7978
Raghu MotaganahalliDivision of Vascular Surgery, Indiana University School of Medicine, Indianapolis (H.A., R.M.).ORCID 0000-0002-9399-2832
Cassius Ochoa ChaarDivision of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale School of Medicine, New Haven, CT (C.O.C.).
Kenneth RosenfieldSection of Vascular Medicine and Intervention Massachusetts General Hospital (K.R.), Harvard Medical School, Boston.ORCID 0000-0002-5633-6983
Salvatore T ScaliDivision of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville (S.T.S., S.K.S., G.R.U.).ORCID 0000-0002-8128-3203
Samir K ShahDivision of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville (S.T.S., S.K.S., G.R.U.).ORCID 0000-0001-6474-1455
Michael B StrongDivision of Vascular and Endovascular Surgery, Brigham and Women's Hospital (M.T.M., M.B.S.), Harvard Medical School, Boston.ORCID 0000-0001-9144-6806
Gilbert R UpchurchDivision of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville (S.T.S., S.K.S., G.R.U.).ORCID 0000-0002-4679-8623
William P RobinsonDivision of Vascular Surgery, Southern Illinois University School of Medicine, Springfield (W.P.R.).ORCID 0000-0002-0150-0758

Funding

NHLBI NIH HHS U01 HL107352NHLBI NIH HHS U01 HL107407NHLBI NIH HHS U01 HL115662
6 · The paper itself

Abstract

backgroundThe impact of age on outcomes after revascularization for chronic limb-threatening ischemia has not been studied in a prospective trial.

methodsA total of 1780 patients were grouped into age quartiles (≤55 years, 55< age ≤65 years, 65< age ≤75 years, and >75 years) and by type of revascularization (open bypass or endovascular). The primary outcome was major adverse limb events (MALE) or death, and the secondary outcomes were above-ankle amputation, reintervention, and major adverse cardiovascular events.

resultsDeath and major adverse cardiovascular events were significantly higher in the oldest quartile (>75 years), whereas MALE and above-ankle amputation were highest in the youngest cohort (≤55 years). Younger patients (≤55 years) had the lowest adjusted risk of MALE or all-cause death with open bypass compared with endovascular revascularization. There was no difference in MALE or all-cause death by treatment strategy in patients >75 years of age.

conclusionsOlder age was associated with the highest risks of death and major adverse cardiovascular events and the lowest risks of MALE and above-ankle amputation among patients enrolled in BEST-CLI (Best Endovascular Versus Best Surgical Therapy in Patients With Chronic Limb-Threatening Ischemia). Age also had a differential impact by revascularization strategy: youngest patients had the lowest risk of MALE and all-cause death with bypass surgery compared with endovascular revascularization, while there was no difference among those >75 years. These data should be used to facilitate shared decision-making in patients with chronic limb-threatening ischemia. REGISTRATION: URL: https://biolincc.nhlbi.nih.gov/studies/best_cli/; Unique identifier: HLB02932424a.

Indexed as

Chronic Limb-Threatening IschemiaEndovascular ProceduresIschemiaPeripheral Arterial DiseaseVascular Surgical ProceduresAgedAged, 80 and overAge FactorsAmputation, SurgicalChronic DiseaseFemaleHumansLimb SalvageMaleMiddle AgedProspective Studiesamputationchronic limb ischemiachronic limb-threatening ischemiaperipheral arterial disease

Identifiers

PMID40177778
PMCPMC12173781

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.