Which trial compared bypass versus angioplasty in severe ischemia of the leg?

Which trial compared bypass versus angioplasty in severe ischemia of the leg?

• A. BASIL multicenter
• B. Nevelle 2009
• C. Uccioli 2018
• D. BASIL 2005

Answer: (A)

In severe limb ischemia from infrainguinal disease, restoring blood flow can be done by open bypass surgery or by endovascular angioplasty. The trial designed to answer which approach is better in this situation is BASIL, which stands for Bypass versus Angioplasty in Severe Ischaemia of the Leg. It was a randomized, multicenter study that directly compared surgical bypass with percutaneous angioplasty as revascularization options and looked at outcomes like amputation-free survival and overall survival. The main takeaway from the BASIL results is nuanced: there isn’t a universal winner overall. Across the initial follow-up, there was no clear difference in amputation-free survival between the two strategies. However, when considering patients with longer expected survival, bypass tended to offer better long-term limb salvage and durability, whereas angioplasty offered advantages for those with limited life expectancy due to lower upfront risk and quicker recovery. This trial informs the choice by emphasizing individual patient prognosis and goals when deciding between bypass and angioplasty.

In severe limb ischemia from infrainguinal disease, restoring blood flow can be done by open bypass surgery or by endovascular angioplasty. The trial designed to answer which approach is better in this situation is BASIL, which stands for Bypass versus Angioplasty in Severe Ischaemia of the Leg. It was a randomized, multicenter study that directly compared surgical bypass with percutaneous angioplasty as revascularization options and looked at outcomes like amputation-free survival and overall survival.

The main takeaway from the BASIL results is nuanced: there isn’t a universal winner overall. Across the initial follow-up, there was no clear difference in amputation-free survival between the two strategies. However, when considering patients with longer expected survival, bypass tended to offer better long-term limb salvage and durability, whereas angioplasty offered advantages for those with limited life expectancy due to lower upfront risk and quicker recovery. This trial informs the choice by emphasizing individual patient prognosis and goals when deciding between bypass and angioplasty.