Quality of Life after Femorocrural Bypass in CLTI: A Double-Center Study Utilizing the SF-36 Questionnaire.

BACKGROUND: Chronic limb-threatening ischemia (CLTI) represents the most severe form of peripheral arterial disease and often leads to amputation limiting the quality of life (QoL) of patients. While femorocrural bypass is an established treatment for CLTI, its impact on patient's QoL has not been thoroughly researched.

METHODS: This prospective, double-center study evaluated 34 patients undergoing femorocrural bypass for the treatment of CLTI utilizing the SF-36 questionnaire. QoL assessments were conducted preoperatively, at discharge, and at 1- and 3-month follow-up, respectively. Primary endpoints included changes in physical and mental QoL. Secondary endpoints included traditional metrics such as primary patency, minor and major amputation, mortality, and palpable foot pulses.

RESULTS: Significant improvement was observed across all SF-36 subscales over time,. While most subscales improved consistently, mental health showed delayed recovery, reaching significance only at later stages. Similar result was also observed for role limitations due to physical health, which improved only after discharge. The study documented a primary patency rate of 93.3%, minor and major amputation rates of 33.3% and 6.7%, and a mortality rate of 11.8%. Postoperative palpable foot pulses were present in 46.7% of patients.

CONCLUSION: Femorocrural bypass surgery for CLTI significantly improves both physical and mental aspects of QoL. These findings highlight the importance of incorporating QoL assessments into outcome measures of surgical treatment of CLTI and underscore the procedure's holistic benefit beyond traditional clinical endpoints.