Nursing-led telephone follow-up after lower limb endovascular surgery: An observational study on early detection and patient safety

Patients undergoing lower limb endovascular surgery remain at high risk for restenosis, reintervention, and limb loss. Structured follow-up may has the potential improve early detection of complications, adherence to preventive therapy, and quality of life.

We conducted a prospective observational cohort study at a tertiary vascular centre in Spain between 2021 and 2023, including 308 patients who underwent infrainguinal endovascular revascularisation. Participants were allocated to nursing-led structured telephone surveillance (n = 154) or usual care (n = 154). Scheduled calls at 1, 3, 6, and 12 months assessed symptoms, wound status, and adherence to secondary prevention. Primary outcome was target-limb reintervention at 12 months. Secondary outcomes included major adverse limb events (MALE), all-cause mortality, medication adherence, quality of life (EQ-5D-5L), and early detection of complications. Group comparisons were performed using inverse probability of treatment weighting (IPTW) based on a propensity score model to account for baseline differences.

At 12 months, target-limb reintervention occurred in 15.6% of the telephone follow-up group versus 26.6% in the usual care group. After adjustment, the association remained significant (adjusted HR 0.61, 95% CI 0.38-0.97, p = 0.039). Major adverse limb events (MALE) occurred in 18.8% versus 31.2% (adjusted HR 0.60, 95% CI 0.38-0.95, p = 0.031). Medication adherence to antiplatelet and statin therapy was higher in the telephone group (92.6% and 89.4% vs 81.4% and 78.1%; p = 0.017). Structured telephone surveillance enabled earlier recognition of vascular warning signs (24.0% vs 7.8%, p < 0.001). Health-related quality of life improved in both groups, but to a greater extent in the telephone group (mean change in EQ-5D-5L index score+0.11 vs +0.06; between-group difference 0.05, 95% CI 0.01-0.09, p = 0.022). No clinical adverse events related to the intervention were observed; mild transient anxiety related to the follow-up was reported in 4 patients (2.6%).

Nursing-led telephone surveillance after lower limb endovascular surgery is safe and effective. It reduces reinterventions and limb events, improves adherence to secondary prevention, and enhances quality of life, providing a scalable model that strengthens continuity of vascular nursing care.