SVS webinar discusses BEST-CLI and early impacts on practice


A recording of the inaugural “SVS Presents” virtual educational session, on the BEST-CLI (Best endovascular vs. best surgical therapy in patients with critical limb ischemia) trial and its effect on vascular surgery, is now available.

More than 150 people joined the webcast, which discussed the results from BEST-CLI. The trial aimed to pinpoint the best treatment for patients with peripher­al arterial disease (PAD) associated with CLI, or chronic limb-threatening ischemia (CLTI); the webcast also dove into what the results mean for the vascular surgery community.

Trial principal investigators, and SVS members Alik Farber, MD, and Matthew Menard, MD, took part. Caitlin Hicks, MD, and Vincent Rowe, MD, moderated. Polling on two questions took place before the webcast, with 81 attendees responding. Surgeons reported on their paradigm for treating CLTI prior to the trial results and whether the results have since changed their practices. Approximately 46% of the respondents reported they performed endovascular therapy first prior to publication of BEST-CLI, while 6% reported they performed open revas­cularization first. Some 68% reported that the decision depended on other patient factors, and 75% reported that they performed open revascu­larization first if an appropriate great saphenous vein (GSV) conduit were available.

Trial results showed surgical bypass with adequate single-segment GSV is a more effective revasculariza­tion strategy for a patient with CLTI who are deemed to be suitable for either an open surgical or endovas­cular approach. They also found that both strategies are safe and effective.

When asked if the BEST-CLI trial results have changed their prac­tices, 28% of respondents replied that they had, 31% said that they hadn’t, and 41% said their decision was pending.

At the conclusion of the webinar, attendees were re-polled about the changing landscape of CLTI care. The majority (61%) of respondents reported “more patients will receive open surgery” based on the results of the trial, 4% reported endovas­cular interventions will take over as first-line therapy despite the trial results, and 35% reported there would be no major changes.

Visit to view the recording.


Please enter your comment!
Please enter your name here