Jeff Nienaber, Manju Kalra, Mateus P. Correa, Jennifer St. Sauver, Carin Smith, Thomas Bower, Audra A. Duncan, Gustavo S. Oderich, Peter Gloviczki
Mayo Clinic, Rochester, MN.
OBJECTIVES: To determine trends in the incidence of amputation and mode of revascularization (endovascular (ENDO) vs. open surgical (OPEN) vs. both (HYBRID)) among persons with peripheral arterial disease (PAD) in a defined population.
METHODS: A population-based cohort study of residents of a single county was conducted from 1990-2009. Procedures were identified by ICD9/CPT codes. Age and gender-adjusted Poisson regression analysis was used to determine 5-year incidence trends.
RESULTS: A total of 773 residents (mean age 68.6 years) underwent 1,906 limb revascularization procedures; 61% for critical limb ischemia (CLI) and 32% for claudication with a median of 2 procedures per limb. The cohort was predominantly male (58.5%, p<0.0001) and Caucasian (96.5%). Initial ENDO procedures were more frequently for claudication (54%) and OPEN for CLI (58%). Five-year incidence rates showed significant decreases in OPEN and increases in ENDO and HYBRID revascularizations over the 20-year period (p<0.001, Figure 1). Total revascularizations increased from 91 to 118 (p=0.0014) and amputations decreased from 21 to 13/100,000 person-years (p=0.0123). Primary amputations decreased from 13 to 5/100,000 person-years (p=0.0002).
CONCLUSIONS: In this population- based study spanning 20 years, the incidence of amputations and OPEN revascularizations decreased significantly among PAD patients, with concomitant increases in total, ENDO and HYBRID revascularizations.
AUTHOR DISCLOSURES: T. Bower:
Nothing to disclose; M. P. Correa:
Nothing to disclose; A. A. Duncan:
Nothing to disclose; P. Gloviczki:
Nothing to disclose; M. Kalra:
Nothing to disclose; J. Nienaber:
Nothing to disclose; G. S. Oderich:
Nothing to disclose; C. Smith:
Nothing to disclose; J. St. Sauver
: Nothing to disclose.
Posted April 2013