Is Global Limb Anatomic Staging System Classification a Useful Tool in Predicting Lower Limb Revascularization Procedures' Success?

IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Andreea Luciana Rata, Nawaf Al Khazaleh, Sergiu Sirca, Cătălin Alexandru Pîrvu, Alexandru Furdui, Elena Rizea, Sorin Barac
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Abstract

Background: GLASS (Global Limb Anatomic Staging System) classification is a classification proposed in 2019 by The Lower Extremity Guidelines Committee of the Society for Vascular Surgery, which aims to identify the anatomic substrate that defines the severity of a lower extremity arterial injury and predict the success rate of possible revascularization. The aim of the study is to demonstrate the usefulness of this classification and if it is a reliable tool in predicting the success of the revascularization procedures for patients with chronic limb-threatening ischemia (CLTI).

Methods: A retrospective study was conducted on patients undergoing revascularization for CLTI. Glass staging was applied to angiographic data, categorizing them into GLASS 1, 2, or 3 based on the complexity of the femoropopliteal and infrapopliteal lesions. We investigated the clinical characteristics and types of endovascular treatment in correlation with GLASS classification. We also evaluated the technical success of revascularization procedures and the specificity and accuracy of the GLASS classification.

Results: After the first testing, we found out that GLASS classification has a sensitivity of 63% and a specificity of 77%. After the second testing, the sensitivity was 82%. of 77% also. The follow-up of this sample was made after 1 year, with no patients lost to follow-up and with an amputation-free survival of 81.3%.

Conclusions: GLASS 1 and 2 patients had significantly higher rates of success compared to GLASS 3. GLASS serves as a valuable tool in predicting revascularization success and provides a standardized approach to anatomical complexity, but further studies should integrate more data in order to enhance its predictive capability.

全球肢体解剖分期系统分类是预测下肢血运重建手术成功的有用工具吗?
背景:GLASS(全球肢体解剖分期系统)分类是血管外科学会下肢指南委员会于2019年提出的一种分类,旨在确定界定下肢动脉损伤严重程度的解剖基础,并预测可能的血运重建成功率。该研究的目的是证明这种分类的有效性,以及它是否是预测慢性肢体威胁缺血(CLTI)患者血运重建手术成功的可靠工具。方法:对行CLTI血运重建术的患者进行回顾性研究。血管造影资料采用玻璃分期,根据股腘窝和股腘窝下病变的复杂性将其分为Glass 1、2或3。我们探讨了血管内治疗的临床特点和类型与GLASS分型的关系。我们还评估了血运重建手术的技术成功以及GLASS分类的特异性和准确性。结果:经过第一次检测,我们发现GLASS分类的敏感性为63%,特异性为77%。第二次检测后,灵敏度为82%。77%的人。该样本于1年后随访,无患者失访,无截肢生存率为81.3%。结论:GLASS 1和GLASS 2患者的成功率明显高于GLASS 3。GLASS是预测血运重建成功的一种有价值的工具,为解剖复杂性提供了标准化的方法,但进一步的研究需要整合更多的数据,以提高其预测能力。
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CiteScore
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