SCAI 2026 Treatment and Management of Complex Peripheral Arterial Disease-BASIL 2 vs BES-CLI: Endo or Surgery First in CLTI, Dr. Thomas

BASIL 2 vs BES-CLI: Endo or Surgery First in CLTI, Dr. Thomas

Video Transcription

Video Summary

The speaker discussed treating a complex CLTI patient with severe ischemia and poor runoff. He reviewed BEST-CLI and BASIL-2, noting bypass may be better in patients with good vein and good surgical candidacy, but many trial endovascular treatments were suboptimal. In this case, the patient declined surgery, and a retrograde endovascular approach successfully reopened the popliteal and tibial vessels with stenting, restoring single-vessel runoff via the peroneal artery. Follow-up showed improved toe pressures, ulcer healing, and patent stents. The takeaway: CLTI care should be patient-centered, multidisciplinary, and tailored to anatomy, experience, and goals.

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Keywords

CLTI

endovascular revascularization

popliteal and tibial stenting

single-vessel runoff

ulcer healing