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Related Experiment Videos

Changing practice patterns in peripheral arterial disease

E F Bernstein1, R B Dilley, W S Thomas

  • 1Division of Vascular and Thoracic Surgery, Scripps Clinic and Research Foundation, La Jolla, Calif. 92037.

Annals of Vascular Surgery
|March 1, 1994
PubMed
Summary
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Interventional radiology has advanced lower extremity peripheral arterial disease (LE-PAD) treatment. While interventions increased, results saw slight improvement, with surgery remaining effective for proximal disease.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Technology

Background:

  • Lower extremity peripheral arterial disease (LE-PAD) management has evolved significantly.
  • Interventional radiologic techniques have become increasingly prominent in treating LE-PAD over the past decade.

Purpose of the Study:

  • To review practice patterns and analyze changing attitudes and results in LE-PAD treatment over five years.
  • To evaluate the outcomes of various interventional and surgical approaches for LE-PAD.

Main Methods:

  • Retrospective review of 603 new LE-PAD patients from three alternate 12-month periods (1987-1992).
  • Analysis included demographics, presenting complaints, treatment modalities (interventional and surgical), and outcomes at one year.
  • Intention-to-treat analysis was employed to assess treatment effectiveness.

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Main Results:

  • A steady increase in the number of patients diagnosed with LE-PAD was observed.
  • Interventional treatment became the primary modality for more patients in the final year.
  • Catheter-based procedure outcomes showed only slight improvement, while surgical outcomes remained excellent; proximal disease operations decreased, with a rise in distal reconstructions.

Conclusions:

  • The approach to LE-PAD treatment has shifted towards interventional techniques.
  • Despite advancements, surgical interventions remain crucial and effective, particularly for proximal disease.
  • Ongoing experience guides the evolution of LE-PAD treatment strategies, balancing interventional and surgical options.