PMID- 35766298
OWN - NLM
STAT- MEDLINE
DCOM- 20230202
LR  - 20230202
IS  - 1827-1839 (Electronic)
IS  - 0392-9590 (Linking)
VI  - 41
IP  - 6
DP  - 2022 Dec
TI  - Routinely ultrasound surveillance improves outcome after endovascular treatment 
      of peripheral arterial disease: propensity-matched comparisons of clinical 
      outcomes after ultrasound or clinical-hemodynamic based surveillance programs.
PG  - 500-508
LID - 10.23736/S0392-9590.22.04900-8 [doi]
AB  - BACKGROUND: Endovascular treatment (EVT) has replaced open repair as the first 
      option in intermittent claudication (IC) and chronic limb-threatening ischemia 
      (CLTI) in several centers. However, evidence of the most optimal post-procedural 
      surveillance strategy is sparse. This study aimed to compare two routine 
      surveillance programs after EVT of IC/CLTI: clinical and hemodynamic assessment 
      (CHA) vs. duplex ultrasound (DUS) and clinical/hemodynamic assessment in 
      combination. METHODS: Between February 2012 and December 2015, all patients with 
      EVT of IC/CLTI were allocated to either CHA or DUS-based routine surveillance 
      programs. The allocation-ratio was 1:2 (CHA:DUS), and propensity score matching 
      (PSM) was used to control baseline differences between the groups. Follow-up 
      visits in the CHA group consisted of clinical assessment and ABI at 3, 6, 12 and 
      24 months. Follow-up visits in DUS group consisted of clinical assessment, ABI, 
      and target vessel DUS at 1, 3, 6, 12, 18 and 24 months. RESULTS: In total, 340 
      legs in 305 patients suffering from IC/CLTI were included; 111 (33%) in the 
      CHA-group and 229 (67%) in the DUS group. The two groups were identical except 
      for a significantly lower incidence of diabetes mellitus in the CHA group than 
      the DUS group, 55% vs. 72%, respectively (P=006). Based on PSM, the CHA-group vs. 
      the DUS-group was burdened of an increased risk of amputation (12.5% vs. 8.27%, 
      HR=0.41 [95% CI: 0.17-0.96]), and a higher mortality (21.2% vs. 12.8%, HR=0.37 
      [95% CI: 0.19-0.72]). The reported differences in reintervention rate (7.5% vs. 
      12.8%, HR=1.12 [95% CI: 0.44-2.84]) were insignificant. The mean follow-up was 
      317 days (SD=0.214) in the CHA group and 611 days (SD=0.298) in the DUS group. 
      CONCLUSIONS: Our results suggest that DUS-based routine surveillance after EVT of 
      IC/CLTI is superior to CHA-based routine surveillance in improved amputation rate 
      and mortality.
FAU - Martinez-Rico, Carlos
AU  - Martinez-Rico C
AD  - Department of Endovascular and Vascular Surgery, Bellvitge University Hospital, 
      Hospitalet de Llobregat, Barcelona, Spain - c.martinez@bellvitgehospital.cat.
AD  - Institut Investigacio Biomedica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 
      Barcelona, Spain - c.martinez@bellvitgehospital.cat.
FAU - Marti-Mestre, Xavier
AU  - Marti-Mestre X
AD  - Department of Endovascular and Vascular Surgery, Bellvitge University Hospital, 
      Hospitalet de Llobregat, Barcelona, Spain.
AD  - Institut Investigacio Biomedica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 
      Barcelona, Spain.
FAU - Cervellera-Perez, Dolors
AU  - Cervellera-Perez D
AD  - Department of Endovascular and Vascular Surgery, Bellvitge University Hospital, 
      Hospitalet de Llobregat, Barcelona, Spain.
FAU - Ramos-Izquierdo, Ricard
AU  - Ramos-Izquierdo R
AD  - Institut Investigacio Biomedica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 
      Barcelona, Spain.
AD  - Department of Thoracic Surgery, Bellvitge University Hospital, Hospitalet de 
      Llobregat, Barcelona, Spain.
FAU - Eiberg, Jonas
AU  - Eiberg J
AD  - Copenhagen Academy for Medical Education and Simulation (CAMES), Department of 
      Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
FAU - Vila-Coll, Ramon
AU  - Vila-Coll R
AD  - Department of Endovascular and Vascular Surgery, Bellvitge University Hospital, 
      Hospitalet de Llobregat, Barcelona, Spain.
AD  - Institut Investigacio Biomedica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 
      Barcelona, Spain.
LA  - eng
PT  - Journal Article
DEP - 20220629
PL  - Italy
TA  - Int Angiol
JT  - International angiology : a journal of the International Union of Angiology
JID - 8402693
SB  - IM
MH  - Humans
MH  - Ischemia/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - *Endovascular Procedures/adverse effects/methods
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - Intermittent Claudication/diagnostic imaging/therapy/etiology
MH  - Limb Salvage
MH  - Hemodynamics
MH  - Risk Factors
MH  - Retrospective Studies
EDAT- 2022/06/30 06:00
MHDA- 2023/02/03 06:00
CRDT- 2022/06/29 06:54
PHST- 2022/06/30 06:00 [pubmed]
PHST- 2023/02/03 06:00 [medline]
PHST- 2022/06/29 06:54 [entrez]
AID - S0392-9590.22.04900-8 [pii]
AID - 10.23736/S0392-9590.22.04900-8 [doi]
PST - ppublish
SO  - Int Angiol. 2022 Dec;41(6):500-508. doi: 10.23736/S0392-9590.22.04900-8. Epub 
      2022 Jun 29.