[The femoral artery: source for a worst case scenario? Possible fatal outcome succeeding the new DRG-system?]

Stenoses and occlusions of the femoral artery mainly cause claudication. Their course is often silent and patients notice it by chance or in a medical checkup. Mayor amputations are rare in isolated femoral appearance of PAOD (peripheral arterial occlusive disease). Although conservative treatment is very effective in these patients, there are still a lot of operations performed, mainly bypasses, interventional dilatations or stenting. The examples of some typical courses out of more than 64,000 vascular disease patients treated in the Hochrheinklinik during the last 24 years point out a new possibility taking a wrong way in treatment decisions. The structure of the new German DRGs stimulates to carry out interventions and operations as there is a great enhancement in earnings. These may result not only in a rise of costs but in a higher risk for patients, too.