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Population-Based Trends in Amputations and Revascularizations for Peripheral Artery Disease From 1990 to 2009.
Nienaber, Jeffrey J; Smith, Carin Y; Cha, Stephen; Correa, Mateus; Rowse, Phillip G; Bailey, Kent R; Kalra, Manju.
Afiliação
  • Nienaber JJ; Division of Vascular and Endovascular Surgery.
  • Smith CY; Division of Biomedical Statistics, Mayo Clinic, Rochester, MN. J.J.N. is currently at the Charles George VA Medical Center, Asheville, NC. M.C. is currently at Instituto Vascular, Passo Fundo, Brazil. P.G.R. is currently in the Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
  • Cha S; Division of Biomedical Statistics, Mayo Clinic, Rochester, MN. J.J.N. is currently at the Charles George VA Medical Center, Asheville, NC. M.C. is currently at Instituto Vascular, Passo Fundo, Brazil. P.G.R. is currently in the Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
  • Correa M; Division of Vascular and Endovascular Surgery.
  • Rowse PG; Division of Vascular and Endovascular Surgery.
  • Bailey KR; Division of Biomedical Statistics, Mayo Clinic, Rochester, MN. J.J.N. is currently at the Charles George VA Medical Center, Asheville, NC. M.C. is currently at Instituto Vascular, Passo Fundo, Brazil. P.G.R. is currently in the Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN.
  • Kalra M; Division of Vascular and Endovascular Surgery. Electronic address: kalra.manju@mayo.edu.
Mayo Clin Proc ; 97(5): 919-930, 2022 05.
Article em En | MEDLINE | ID: mdl-35177249
OBJECTIVE: To determine trends in amputations and revascularizations for peripheral artery disease (PAD) in a well-defined population. METHODS: A population-based cohort study of Olmsted County, Minnesota, residents with PAD undergoing amputation or revascularization was conducted between January 1, 1990, and December 31, 2009. Population-level 5-year incidence trends for endovascular, open surgical, and hybrid revascularizations and major and minor amputations were determined. Limb-specific outcomes after revascularization, including major adverse limb events and amputation-free survival, were compared between initial surgical and endovascular or hybrid revascularization groups using Kaplan-Meier analysis. RESULTS: We identified 773 residents who underwent 1906 limb-procedures, including 689 open revascularizations, 685 endovascular or hybrid revascularizations, and 220 major amputations. During the 20-year study period, the incidence of endovascular and hybrid revascularizations increased, whereas the incidence of open surgical revascularizations and major amputations decreased. Incidence of revascularizations for chronic limb-threatening ischemia (CLTI) did not change. Among residents with CLTI undergoing their first revascularization on a limb, endovascular revascularization was associated with more major adverse limb events and major amputations compared with surgical revascularization during the ensuing 15 years. CONCLUSION: The rising incidence of endovascular and hybrid revascularizations and the decreasing incidence of open surgical revascularizations for PAD were associated with a decreasing incidence of major amputations in this population between 1990 and 2009, despite a stable incidence of revascularizations for CLTI. With more major adverse limb events and major amputations after endovascular revascularization, these trends suggest that additional emphasis should be placed on improving limb salvage efforts beyond just mode of revascularization.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença Arterial Periférica / Procedimentos Endovasculares Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Mayo Clin Proc Ano de publicação: 2022 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença Arterial Periférica / Procedimentos Endovasculares Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Mayo Clin Proc Ano de publicação: 2022 Tipo de documento: Article País de publicação: Reino Unido