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Related Concept Videos

Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...

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Related Experiment Video

Updated: May 14, 2026

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
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Published on: September 22, 2020

Benchmarking Surgeon Performance in Lower Extremity Revascularization Using a Composite Outcome Metric.

Radha Bansal1, Isabella Ferlini Cieri1, Shezan Fouzdar1

  • 1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Annals of Vascular Surgery
|May 12, 2026
PubMed
Summary
This summary is machine-generated.

Surgeon performance in limb salvage for peripheral artery disease was consistent across operators. Higher-volume surgeons showed numerically lower blood loss and better composite scores, indicating a volume-outcome relationship.

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Area of Science:

  • Vascular Surgery
  • Health Services Research
  • Quality Improvement

Background:

  • Peripheral artery disease (PAD) programs require consistent surgical outcomes for limb salvage.
  • Surgeon-level benchmarking is limited despite the known influence of procedural volume.
  • The Limb Evaluation and Amputation Prevention Program (LEAPP) is a multidisciplinary limb salvage initiative.

Purpose of the Study:

  • Analyze surgeon performance in limb salvage for PAD.
  • Investigate volume-outcome patterns using a composite quality assessment framework.

Main Methods:

  • Single-center study of 147 PAD patients undergoing lower extremity revascularization.
  • Primary outcome: adverse event-free survival (AEFS) at 1 year.
  • Surgeon performance assessed via composite z-score (adverse event rates, O/E ratios, hazard ratios).

Main Results:

  • 70.5% had chronic limb-threatening ischemia; 21.1% experienced an adverse event (bleeding, thrombosis, amputation).
  • No significant differences in AEFS or complication rates across surgeons.
  • Higher-volume surgeons had numerically lower intraoperative blood loss and positive composite z-scores.

Conclusions:

  • Surgeon-level outcomes in PAD limb salvage were consistent.
  • A directional volume-outcome relationship was observed, with higher-volume surgeons performing better.
  • The composite scoring framework is a feasible tool for surgeon benchmarking and quality improvement.