{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T03:17:46Z","timestamp":1790479066569,"version":"4.1.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Critical limb ischemia (\n                      <jats:styled-content style=\"fixed-case\">CLI<\/jats:styled-content>\n                      ) is increasing in prevalence, and remains a significant source of mortality and limb loss. The decision to recommend surgical or endovascular revascularization for patients who are candidates for both varies significantly among providers and is driven more by individual preference than scientific evidence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The Best Endovascular Versus Best Surgical Therapy for Patients With Critical Limb Ischemia (BEST\u2010CLI) Trial is a prospective, randomized, multidisciplinary, controlled, superiority trial designed to compare treatment efficacy, functional outcomes, quality of life, and cost in patients undergoing best endovascular or best open surgical revascularization. Approximately 140 clinical sites in the United States and Canada will enroll 2100 patients with\n                      <jats:styled-content style=\"fixed-case\">CLI<\/jats:styled-content>\n                      who are candidates for both treatment options. A pragmatic trial design requires consensus on patient eligibility by at least 2 investigators, but leaves the choice of specific procedural strategy within the assigned revascularization approach to the individual treating investigator. Patients with suitable single\u2010segment of saphenous vein available for potential bypass will be randomized within Cohort 1 (n=1620), while patients without will be randomized within Cohort 2 (n=480). The primary efficacy end point of the trial is Major Adverse Limb Event\u2013Free Survival. Key secondary end points include Re\u2010intervention and Amputation\u2010Free\u2010Survival and Amputation Free\u2010Survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The\n                      <jats:styled-content style=\"fixed-case\">BEST<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">CLI<\/jats:styled-content>\n                      trial is the first randomized controlled trial comparing endovascular therapy to open surgical bypass in patients with\n                      <jats:styled-content style=\"fixed-case\">CLI<\/jats:styled-content>\n                      to be carried out in North America. This landmark comparative effectiveness trial aims to provide Level I data to clarify the appropriate role for both treatment strategies and help define an evidence\u2010based standard of care for this challenging patient population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n                      :\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/\">https:\/\/www.clinicaltrials.gov\/<\/jats:ext-link>\n                      . Unique identifier:\n                      <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n                      02060630.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.116.003219","type":"journal-article","created":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T03:13:00Z","timestamp":1468293180000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":179,"title":["Design and Rationale of the Best Endovascular Versus Best Surgical Therapy for Patients With Critical Limb Ischemia (BEST\u2010CLI) Trial"],"prefix":"10.1161","volume":"5","author":[{"given":"Matthew T.","family":"Menard","sequence":"first","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alik","family":"Farber","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan F.","family":"Assmann","sequence":"additional","affiliation":[{"name":"New England Research Institute, Watertown, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niteesh K.","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Conte","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, University of California San Francisco Medical Center, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Creager","sequence":"additional","affiliation":[{"name":"Dartmouth\u2010Hitchcock Heart and Vascular Center, Dartmouth\u2010Hitchcock Medical Center, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Dake","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford Hospital and Clinics, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Jaff","sequence":"additional","affiliation":[{"name":"Fireman Vascular Center, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Dotter Interventional Institute\/OHSU, Portland, OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Powell","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Dartmouth\u2010Hitchcock Medical Center, Lebanon, NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane M.","family":"Reid","sequence":"additional","affiliation":[{"name":"National Heart, Lung and Blood Institute, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora Sandra","family":"Siami","sequence":"additional","affiliation":[{"name":"New England Research Institute, Watertown, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Sopko","sequence":"additional","affiliation":[{"name":"National Heart, Lung and Blood Institute, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ochsner Medical Center, New Orleans, LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Rosenfield","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"S5","article-title":"Inter\u2010society consensus for the management of peripheral arterial disease (TASC II)","volume":"45","author":"Norgren L","year":"2007","unstructured":"Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FGR. Inter\u2010society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg. 2007;45:S5\u2013S67.","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000137913.26087.F0"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530020083037"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(96)80257-7"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.10.089"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv006"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199510000-00003"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.08.033"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(86)90073-X"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.09.044"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.03.281"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.1007"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24485"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.07.099"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.02.001"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(11)60014-2"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.01.035"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.01.031"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.621391"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.962233"},{"key":"e_1_3_3_22_2","unstructured":"Cronenwett JL. \u201cSVS vascular quality initiative annual report: national data analyses\u201d. Presented at the Vascular Annual Meeting of the Society for Vascular Surgery San Francisco CA June 1 2013."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.10.009"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.023"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.08.036"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2008.11.008"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67704-5"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.01.073"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2015.01.003"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.tvir.2014.08.012"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540350075038"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.09.045"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.07.005"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1098-3015(11)70482-X"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8510(90)90421-9"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(97)80070-6"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199603000-00003"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.007002"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.01.076"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2005.00045.x"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.08.003"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780131308"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2004.07.043"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.003219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:13:04Z","timestamp":1715580784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.003219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,6]]},"references-count":42,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7,6]]}},"alternative-id":["10.1161\/JAHA.116.003219"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.003219","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.726500891.793570993","asserted-by":"object"}]},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,6]]},"assertion":[{"value":"2016-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-04-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e003219"}}