{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:45:44Z","timestamp":1791477944711,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T00:00:00Z","timestamp":1725667200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017691","name":"Guangxi Key Research and Development Program","doi-asserted-by":"publisher","award":["2021AB11027"],"award-info":[{"award-number":["2021AB11027"]}],"id":[{"id":"10.13039\/501100017691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82260448"],"award-info":[{"award-number":["82260448"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The clinical management of patients with chronic limb\u2010threatening ischemia (CLTI) faces great challenges. Enhancing wound healing and limb preservation rates in this cohort is a critical objective. This study investigates the effectiveness of combining tibial cortex transverse transport (TTT) and endovascular therapy (EVT) for the treatment of patients with severe CLTI. We aim to evaluate the therapeutic results of this combined approach on the specified patient group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study to compare EVT with the combination of TTT and EVT in patients (Rutherford category 5 and above) with CLTI at Guangxi Medical University's First Affiliated Hospital from June 2017 to June 2023. This cohort was subjected to a follow\u2010up period ranging from a minimum of 6\u2009months to a maximum of 12\u2009months. The primary outcome measures included amputation\u2010free survival (AFS) (avoidance of above\u2010ankle amputation or death from any cause), overall mortality, limb salvage rates, wound healing efficiency, and the technical efficacy of the applied treatments. A variety of statistical analyses including chi\u2010square tests, Fisher's exact tests, and Pearson's and Spearman's correlation analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, 131 patients with CLTI were included: 76 in the control group receiving only EVT treatment and 55 in the TTT\u2009+\u2009EVT group. The two groups were matched on demographic and clinical characteristics. In the TTT\u2009+\u2009EVT group, after more than 6\u2009months of follow\u2010up, 85.5% of patients achieved AFS, and wound healing was observed in 54.5% (30 of 55 patients). After more than 12\u2009months of follow\u2010up, 81.9% achieved AFS, with wound healing in 32 patients. Furthermore, after more than 24\u2009months, 74.2% of patients remained amputation\u2010free, with wound healing in all surviving patients. In the control group, after more than 6\u2009months of follow\u2010up, 72.4% of patients achieved AFS, and wound healing was observed in 51.3% (39 of 96 patients). After more than 12\u2009months, 48.9% achieved AFS, with wound healing in 21 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found that combining therapy of TTT and EVT is safe and can be successfully administered in patients with CLTI and it enhances wound healing and AFS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14222","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T09:34:59Z","timestamp":1725701699000},"page":"2132-2139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Combining Tibial Cortex Transverse Transport (<scp>TTT<\/scp>) and Endovascular Therapy (<scp>EVT<\/scp>) for Limb Salvage in Chronic Limb\u2010Threatening Ischemia"],"prefix":"10.1111","volume":"16","author":[{"given":"Yi","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Bone and Joint Surgery The First Affiliated Hospital of Guangxi Medical 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