在外周血管干预期间使用血管内超声波进行音并没有与改善的结果有关
Chen Dun1, M Libby Weaver2, Sanuja Bose3
1Department of Biomedical Informatics and Data Science, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Annals of vascular surgery
|May 1, 2025
概括
血管内超声波 (IVUS) 的使用正在增加,用于音患者的外周血管干预 (PVIs). 然而,IVUS没有显示出明显的益处,并且在一项研究中与更高的风险有关.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 健康 结果 研究 研究 结果
背景情况:
- 血管内超声波 (IVUS) 提高外周血管干预 (PVIs) 结果的有效性仍未得到充分研究.
- 这项研究评估了IVUS使用与PVI进行音治疗的患者的长期结果之间的关联.
研究的目的:
- 评估IVUS对患有骨骨PVI患者的长期结果的影响.
- 分析IVUS在不同环境和程序中的使用趋势.
主要方法:
- 一项利用医疗保险服务费索赔 (2018-2022) 和血管质量倡议 (VISION; 2016-2019) 的两组队列研究.
- 包括接受关节指数PVI的患者,不包括患有慢性肢体威胁性缺血症 (CLTI) 或急性肢体缺血症的患者.
- 多变量Cox比例危险模型被用于评估IVUS与重复PVI,CLTI转换和截肢的关联,并根据患者特征和解剖因素进行调整.
主要成果:
- 在医疗保险队列中 (N=69,092),22.1%接受了IVUS;在VISION队列中 (N=6,722),3.8%接受了IVUS.
- 随着时间的推移,IVUS的使用显著增加,特别是在门诊机构和切除术中.
- 医疗保险数据显示,IVUS与重复PVI (aHR 1.07) 和进展到CLTI (aHR 1.11) 的更高危险相关;VISION数据没有发现显著的结果差异.
结论:
- 血管内超声波 (IVUS) 用于音治疗的使用正在迅速增加.
- 目前的证据并未证明IVUS在改善该患者群体的结果方面具有明显的益处.
- 需要进一步调查,以澄清IVUS在管理病中的作用.
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