Contemporary Outcomes of Distal Lower Extremity Bypass for Chronic Limb-Threatening Ischemia and A Model-Based Comparison With Autologous Bone Marrow-Derived Cell Therapy for Limb Preservation

Abstract

The standard of therapy for chronic limb-threatening ischemia (CLTI) is revascularization. However, for patients for whom below-the-knee bypass is indicated, an autologous great saphenous vein (GSV), the optimal conduit, might not be available. For these patients, an alternative conduit, such as a synthetic or cryopreserved biologic graft, will be necessary. Contemporary outcomes of distal bypass with these suboptimal conduits have not been well described, and recent advances in novel nonoperative management such as autologous bone marrow cell (BMC) therapy warrant a comparative analysis as a potential alternative for limb preservation.