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 PS128. Population-Based Study of 20-Year Trends in Lower Extremity Revascularizations and Amputations Among Persons with Peripheral Arterial Disease

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.


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Posted April 2013

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