학술논문

The Contemporary Safety and Effectiveness of Lower Extremity Bypass Surgery and Peripheral Endovascular Interventions in the Treatment of Symptomatic Peripheral Arterial Disease.
Document Type
article
Source
Circulation. 132(21)
Subject
comparative effectiveness research
lower extremity bypass surgery
peripheral arterial disease
Aged
Amputation
Surgical
California
Colorado
Comorbidity
Delivery of Health Care
Integrated
Endovascular Procedures
Female
Humans
Incidence
Intermittent Claudication
Ischemia
Kaplan-Meier Estimate
Lower Extremity
Male
Middle Aged
Peripheral Arterial Disease
Postoperative Complications
Registries
Retrospective Studies
Surgical Wound Infection
Treatment Outcome
Vascular Surgical Procedures
Language
Abstract
BACKGROUND: Treatment for symptomatic peripheral artery disease includes lower extremity bypass surgery (LEB) and peripheral endovascular interventions (PVIs); however, limited comparative effectiveness data exist between the 2 therapies. We assessed the safety and effectiveness of LEB and PVI in patients with symptomatic claudication and critical limb ischemia. METHODS AND RESULTS: In a community-based clinical registry at 2 large integrated healthcare delivery systems, we compared 883 patients undergoing PVI and 975 patients undergoing LEB between January 1, 2005 and December 31, 2011. Rates of target lesion revascularization were greater for PVI than for LEB in patients presenting with claudication (12.3±2.7% and 19.0±3.5% at 1 and 3 years versus 5.2±2.4% and 8.3±3.1%, log-rank P