A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial.
Bradbury AW, Moakes CA, Popplewell M, Meecham L, Bate GR, Kelly L et al, on behalf of the BASIL-2 Investigators.
Lancet 2023; 401: 1798-1809.
Some 345 patients with critical leg ischaemia were treated and followed for two years. The outcome of major amputation or death occurred in 63 per cent of the surgery first group compared to 53 per cent after endovascular treatment first, P=0 .037. This outcome was mainly due to the high rate of death in the two years after surgery (53 versus 45 per cent).
Comment: This was an unexpected result after the converse outcome in the recent BestCLI trial. It requires further explanation. Were the patients with critical leg ischaemia different in the UK and USA?
30 May 2023
Read paperAcademy
Part of the charitable activity of the Foundation, BJS Academy is an online educational resource for current and future surgeons.
The Academy is comprised of five distinct sections: Continuing surgical education, Young BJS, Cutting edge, Scientific surgery and Surgical news. Although the majority of this is open access, additional content is available to BJS subscribers and strategic partners.
