在住院和门诊治疗环境中使用atherctomy和栓塞保护装置的实践模式
Alexandra A Sansosti1, Jose Munoz2, Andrew N Lazar3
1Division of Vascular Surgery, Department of Surgery, Columbia University Medical Center, New York, NY.
Journal of vascular surgery
|June 29, 2024
概括
在办公室实验室 (OBLs) 进行的动脉切除显示了下栓保护装置 (EPD) 的使用,但没有增加并发症. 然而,OBL手术与下肢动脉疾病的两年内更高的再干预率相关.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 下肢动脉疾病的动脉切除术正在增加,特别是在办公室实验室 (OBL).
- 切除术的疗效和栓塞保护装置 (EPD) 在OBL中的影响仍在调查中.
- 了解住院患者与OBL环境中的资源使用和结果至关重要.
研究的目的:
- 为了比较资源使用和术后的结果,在住院病人与OBL设置中的atherctomy.
- 分析EPD在股骨关节动脉疾病干预中的使用情况.
- 评估与OBL相关的再干预率与住院患者的切除术.
主要方法:
- 对于股骨 - 骨封闭性疾病 (2017-2021) 的内血管干预措施的回顾性分析.
- 一个:一个贪的匹配和调整的分析比较住院和OBL设置.
- 对结果分析的等级后勤回归和比例危险模型.
主要成果:
- 分析了2849个匹配对;EPD使用率总体为22% (40%住院患者,4.4%的OBL).
- 在控制变量后,在OBL和住院患者之间没有观察到术后并发症的显著差异.
- 整形骨髓切除术与在2年内再次干预的可能性增加18%有关.
结论:
- 与医院相比,OBL中的EPD使用率显著降低,但直接并发症的比例没有相应增加.
- 在OBL中进行的动脉切除术与在两年内再次进行ipsilateral干预的可能性更高有关.
- 建议进行进一步的研究,以确保患者的安全性和OBL切除术的长期疗效.
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