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首页> 外文期刊>Vascular and endovascular surgery >High Reintervention and Amputation Rates After Outpatient Atherectomy for Claudication
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High Reintervention and Amputation Rates After Outpatient Atherectomy for Claudication

机译：在门诊发生后的高层重新入住和截肢率，用于歧视

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Outpatient use of atherectomy for peripheral arterial disease has grown rapidly and outcomes are poorly understood. We analyzed outcomes of atherectomy done for claudication, comparing office and hospital outpatient settings. Analysis of Medicare Part B claims data was performed for incident femoral-popliteal or tibial-peroneal atherectomy from 2012 to 2014. Longitudinal analysis assessed services 18 months before, during, and up to 18 months after the incident peripheral vascular intervention (PVI). Differences between office-based and hospital outpatient-based settings were assessed using (2) and Fisher exact tests. Comparing procedure settings, significant differences in race (femoral-popliteal: P = .04, tibial-peroneal: P = .001), chronic renal failure (femoral-popliteal: P = .002), and hypertension (femoral-popliteal: P = .01, tibial-peroneal: P = .006) were found. Nine hundred twenty-four patients undergoing femoral-popliteal atherectomy were analyzed (262 office based, 662 hospital outpatient based); 42.7% of office-based and 36.9% of hospital outpatient-based femoral-popliteal atherectomy patients had repeat PVI within 18 months (P = .10). Major amputation was performed in 2.3% and 3.2% of patients in office and hospital outpatient settings, respectively (P = .47). Four hundred twenty-three patients undergoing tibial-peroneal atherectomy were analyzed (202 office based, 221 hospital outpatient based); 46.5% of office-based and 38.9% of hospital outpatient-based tibial-peroneal atherectomy patients had repeat PVI within 1 year (P = .11). Major amputation was performed in 5.0% and 8.1% of patients in office and hospital outpatient settings, respectively (P = .19). Our study demonstrates higher than expected rates of major amputation for patients undergoing peripheral arterial atherectomy with regard to previously reported rates. Further studies may be required to prove the efficacy and safety of atherectomy for occlusive disease in the femoral-popliteal and tibial-peroneal segments to ensure outcomes are not worse than the natural history of medically managed claudicants.
机译：外周动脉疾病的门诊使用速度迅速，结果差不多。我们分析了对克划的粥样斑块切除术的结果，比较办公室和医院门诊设置。 Medicare B部分的分析B部分来自2012年至2012年的事件股骨疫苗膜炎或胫骨膜粥样族粥样切除术进行了索赔数据。入射外周血管干预（PVI）前，期间和最多18个月的纵向分析评估服务18个月。使用（2）和Fisher精确测试评估了基于办公室和基于医院外部的设置的差异。比较程序设置，种族差异显着差异（股骨流连放性：P = .04，胫骨运动：P = .001），慢性肾功能衰竭（股育雏类：P = .002）和高血压（股份有Popliteal：P发现= .01，发现胫骨运动：p = .006）。分析了九十四名接受股育雏发生术的患者（262名，基于662家住院门诊）; 42.7％的基于办公室和36.9％的医院门诊股育雏粥样切除术患者在18个月内重复PVI（P = .10）。主要截肢分别在办公室和医院门诊设置的2.3％和3.2％的患者中进行（P = .47）。分析了四百次接受胫骨膜粥粥粥切除术的患者（202个办公室，221家住院门诊）;基于办事处的46.5％和38.9％的医院门诊的胫骨膜术术患者在1年内重复PVI（P = .11）。主要截肢分别在办公室和医院门诊设置的5.0％和8.1％的患者中进行（P = .19）。我们的研究表明，对于先前报告的速率，对接受外周血动脉间隙的患者的主要截肢率高。可能需要进一步的研究来证明股骨育下和胫骨膜术和胫骨膜细分细分中闭塞性疾病的疗效和安全性，以确保结果不如医学管理克拉欺骗的自然历史。

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