Division
East Florida
Hospital
HCA Florida Aventura Hospital
Specialty
Transitional Year
Document Type
Poster
Publication Date
2023
Keywords
chronic limb-threatening ischemia, peripheral artery disease, PAD, surgical vascularization
Disciplines
Medicine and Health Sciences | Surgical Procedures, Operative
Abstract
Abstract: Chronic limb-threatening ischemia (CLTI) is a serious condition that can lead to amputation and even death. Open and endovascular revascularization are two common treatment options for CLTI, but the optimal treatment approach remains controversial. This study compared the 30-Day outcomes of open and endovascular revascularization using data from the National Surgical Quality Improvement Program (NSQIP) database. The study included 6,780 patients who underwent open bypass with saphenous vein, 4,201 patients who underwent open bypass with alternative conduit, and 8,887 patients who underwent endovascular intervention. Compared to open bypass with saphenous vein, endovascular intervention was associated with a higher rate of major amputation (1.4% vs. 1.0%, p=0.002) and major adverse limb events (MALE, 2.8% vs. 2.1%, p=0.004). However, endovascular intervention was also associated with a lower rate of major adverse cardiovascular events (MACE, 1.6% vs. 3.5%, p<0.001). Compared to open bypass with alternative conduit, endovascular intervention was associated with a similar rate of major amputation (1.4% vs. 1.2%, p=0.763), MALE (2.8% vs. 2.2%, p=0.34), and MACE (1.6% vs. 3.3%, p=0.053). These findings suggest that endovascular intervention may be a safe and effective treatment option for CLTI, but it is important to carefully select patients who are likely to benefit from this approach. Patients with complex lesions or severe comorbidities may be better candidates for open bypass surgery.
Conclusion: This study provides valuable insights into the 30-Day outcomes of open versus endovascular revascularization for CLTI. The findings suggest that endovascular intervention may be a safe and effective treatment option for selected patients, but careful patient selection is essential.
Recommended Citation
Kosoy, David and Wahood, Waseem, "Comparing 30-Day Outcomes of Open Versus Endovascular Revascularization for Chronic Limb-Threatening Ischemia" (2023). East Florida Research Day 2023. 33.
https://scholarlycommons.hcahealthcare.com/eastflorida2023/33
Abstract