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Effects of the development of modern vascular services on amputation rates in Leicester, U.K.: a preliminary report
R D Sayers1, M M Thompson, K Varty
1Department of Surgery, Leicester Royal Infirmary, U.K.
Insights
Treatments for lower limb peripheral vascular disease evolved between 1974 and 1990. Arterial reconstructions and angioplasties increased, while major amputation rates saw a slight, non-significant decrease.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Public Health
Background:
- Peripheral vascular disease (PVD) management has evolved significantly.
- Lower limb PVD poses a substantial health burden, historically leading to amputation.
Purpose of the Study:
- To analyze trends in treatment modalities for lower limb PVD.
- To assess changes in arterial reconstruction, angioplasty, and amputation rates over a 17-year period.
Main Methods:
- Retrospective review of 3036 patients treated for lower limb PVD.
- Data sourced from the Hospitals Activity Analysis database (1974-1990).
- Analysis of procedures including arterial reconstruction, percutaneous transluminal angioplasty, and major amputation.
Main Results:
- A notable increase in arterial reconstructions and percutaneous transluminal angioplasties was observed.
- The overall rate of major amputations for lower limb PVD showed a slight decrease.
- The reduction in amputation rates was not statistically significant over the study period.
Conclusions:
- Arterial reconstruction and angioplasty have become more prevalent treatments for lower limb PVD.
- While amputation rates slightly declined, they remain a significant outcome.
- Further research is needed to understand factors influencing these treatment trends and outcomes.
Abstract:
We have reviewed 3036 consecutive patients who underwent arterial reconstruction, percutaneous transluminal angioplasty, or a major amputation for lower limb peripheral vascular disease in Leicester between 1974 and 1990. Patient data were obtained from the Hospitals Activity Analysis database, which codes all patient discharges according to diagnosis and treatment. During this 17-year study period, 1132 patients have undergone arterial reconstruction, 706 patients have undergone percutaneous transluminal angioplasty, and 1198 patients have undergone major amputation. The results show that the number of arterial reconstructions and angioplasties for lower limb arterial occlusive disease has increased over the last 17 years. The total amputation rate has decreased slightly during the period studied, but overall the decrease has not been significant.