{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:28:31Z","timestamp":1790162911367,"version":"4.1.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,4,16]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>In the BEST-CLI trial (Best Endovascular Versus Best Surgical Therapy for Patients With Chronic Limb-Threatening Ischemia), a prespecified secondary objective was to assess the effects of revascularization strategy on health-related quality of life (HRQoL).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Patients with chronic limb-threatening ischemia were randomized to surgical bypass (Bypass) or endovascular intervention (Endo) in 2 parallel trials. Cohort 1 included patients with single-segment great saphenous vein; cohort 2 included those lacking suitable single-segment great saphenous vein. HRQoL was assessed over the trial duration using Vascular Quality-of-Life (VascuQoL), European Quality-of-Life-5D (EQ-5D), the Short Form-12 (SF-12) Physical Component Summary (SF-12 PCS), SF-12 Mental Component Summary (SF-12 MCS), Utility Index Score (SF-6D R2), and numeric rating scales of pain. HRQoL was summarized by cohort and compared within and between groups using mixed-model linear regression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A total of 1193 and 335 patients in cohorts 1 and 2 with a mean follow-up of 2.9 and 2.0 years, respectively, were analyzed. In cohort 1, HRQoL significantly improved from baseline to follow-up for both groups across all measures. For example, mean (SD) VascuQoL scores were 3.0 (1.3) and 3.0 (1.2) for Bypass and Endo at baseline and 4.7 (1.4) and 4.8 (1.5) over follow-up. There were significant group differences favoring Endo when assessed with VascuQoL (difference, \u20130.14 [95% CI, \u20130.25 to \u20130.02];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.02), SF-12 MCS (difference, \u20131.03 [95% CI, \u20131.89 to \u20130.18];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.02), SF-6D R2 (difference, \u20130.01 [95% CI, \u20130.02 to \u20130.001];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.03), numeric rating scale pain at present (difference, 0.26 [95% CI, 0.03 to 0.49];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.03), usual level during previous week (difference, 0.26 [95% CI, 0.04 to 0.48];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.02), and worst level during previous week (difference, 0.29 [95% CI, 0.02 to 0.56];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.04). There was no difference between treatment arms on the basis of EQ-5D (difference, \u20130.01 [95% CI, \u20130.03 to 0.004];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.12) or SF-12 PCS (difference, \u20130.41 [95% CI, \u20131.2 to 0.37];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.31). In cohort 2, HRQoL also significantly improved from baseline to the end of follow-up for both groups based on all measures, but there were no differences between Bypass and Endo on any measure.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Among patients with chronic limb-threatening ischemia deemed eligible for either Bypass or Endo, revascularization resulted in significant and clinically meaningful improvements in HRQoL. In patients with an available single-segment great saphenous vein for bypass, but not among those without one, Endo was statistically superior on some HRQoL measures; however, these differences were below the threshold of clinically meaningful difference.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.123.065277","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T09:00:26Z","timestamp":1712739626000},"page":"1241-1253","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Quality of Life in Patients With Chronic Limb-Threatening Ischemia Treated With Revascularization"],"prefix":"10.1161","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2470-7978","authenticated-orcid":true,"given":"Matthew T.","family":"Menard","sequence":"first","affiliation":[{"name":"Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.), Harvard Medical School, Boston, 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