Common Criticisms and Rebuttals of the Best Endovascular Versus Best Surgical Therapy in Patients with Chronic Limb-Threatening Ischemia (BEST-CLI) Trial

Olivia D'Angelo; Matthew T Menard; Alik Farber

doi:10.1016/j.avsg.2023.12.100

Common Criticisms and Rebuttals of the Best Endovascular Versus Best Surgical Therapy in Patients with Chronic Limb-Threatening Ischemia (BEST-CLI) Trial

Ann Vasc Surg. 2024 Apr 8:S0890-5096(24)00149-3. doi: 10.1016/j.avsg.2023.12.100. Online ahead of print.

Authors

Olivia D'Angelo¹, Matthew T Menard², Alik Farber³

Affiliations

¹ Division of Vascular & Endovascular Surgery, Boston University School of Medicine, Boston, MA. Electronic address: olivia.dangelo7@gmail.com.
² Division of Vascular Surgery, Brigham and Women's Hospital, Boston, MA.
³ Division of Vascular & Endovascular Surgery, Boston University School of Medicine, Boston, MA.

PMID: 38599479
DOI: 10.1016/j.avsg.2023.12.100

Abstract

The Best Endovascular Versus Best Surgical Therapy in Patients With Chronic Limb-Threatening Ischemia trial was a landmark trial which provides high-quality data for the decision-making regarding the treatment of chronic-limb threatening ischemia. Overall, the trial suggests that in patients with adequate greater saphenous vein conduit, bypass surgery should be offered as a first line treatment given superior outcomes. In this article, we outline the common critiques of the trial, followed by responses to provide a deeper understanding of the strengths and limitations of this important trial.