2026 Volume 7 Issue 2 Pages 148-153
Objectives: This single-center prospective observational study aimed to investigate ambulatory function (AF) after distal bypass (DB) for chronic limb-threatening ischemia (CLTI). Approval was obtained from the regional Ethics Committee.
Methods: Between 2020 and 2023, 200 CLTI patients underwent DB using a vein grafting. We enrolled 92 patients, including 12 with intermittent claudication (IC) and 80 with CLTI, all of whom remained free of major adverse events during 12 months of follow-up. AF was evaluated by monthly mean-steps/day (mSs/d), required time to achieve ≥ 1,000 mSs/d, maximum-mSs/d, and 12-month mSs/d.
Results: Recovery to ≥ 1,000 mSs/d was achieved in 2 months for 92% of IC patients and in 3 months for 85% of CLTI patients. The IC group demonstrated a steep increase in mSs/d within 2 months, whereas the CLTI group showed a gradual monthly recovery over 12 months, with no influence from the severity of tissue loss. The maximum and 12-month mSs/d values were 6,629 (at 6 months) and 4,758 in the IC group, compared with 3,051 (at 9 months) and 2,923 in the CLTI group, respectively.
Conclusion: Recovery to ≥ 1,000 mSs/d was achieved within 2 months in 92% of patients with IC and within 3 months in 85% of patients with CLTI, with significant differences between the two groups. In the homogenized cohorts, patient characteristics had no significant influence on AF recovery.
