Abstract：
BACKGROUND: The aim of the study is to compare the short-term and medium-term outcomes in patients who underwent open repair (OR) or endovascular repair (ER) for peripheral arterial disease (PAD) also including stratifications based on severity and year of the first intervention.
METHODS: We conducted an observational retrospective single-center cohort study. We evaluated patients with PAD that primarily underwent ER, OR, minor, and major amputations in a single center from 2005 to 2020. The patients were then subdivided according to the type of intervention (OR versus ER), and stratified according to the International Classification of Diseases 9 code reported in the operating documents and to the year intervention. Mortality, minor, and major amputation rates occurring at 30 days, 2 years, and 5 years after the first intervention were evaluated as primary outcomes and compared between patient groups in both stratifications. Moreover, Kaplan-Maier curves were analyzed for these outcomes.
RESULTS: One thousand four hundred ninety two patients (67.0% males) with PAD were evaluated. Their clinical presentations were intermittent claudication in 51.4% of cases, rest pain in 16.8%, ulcers in 10.3%, and gangrene in 21.5%. Nine hundred ninety seven (66.8%) underwent OR and 495 (33.2%) ER as first intervention for PAD. No statistical differences were observed in terms of mortality in the 2 groups (OR versus ER, P = 1,000, P = 0.357, and P = 0.688 at 30 days, 2 years, and 5 years, respectively). The rate of minor amputations was significantly higher (P < 0.012, P < 0.002, and P < 0.007 at 30 days, 2 years, and 5 years, respectively) for ER group in any of the observed follow-up periods. Also, we have observed that OR and ER do not have any significant short-term and medium-term major amputation rate differences.
CONCLUSIONS: In our experience, the impact of ER does not significantly change short-term and mid-term major outcomes in patients with PAD.
METHODS: We conducted an observational retrospective single-center cohort study. We evaluated patients with PAD that primarily underwent ER, OR, minor, and major amputations in a single center from 2005 to 2020. The patients were then subdivided according to the type of intervention (OR versus ER), and stratified according to the International Classification of Diseases 9 code reported in the operating documents and to the year intervention. Mortality, minor, and major amputation rates occurring at 30 days, 2 years, and 5 years after the first intervention were evaluated as primary outcomes and compared between patient groups in both stratifications. Moreover, Kaplan-Maier curves were analyzed for these outcomes.
RESULTS: One thousand four hundred ninety two patients (67.0% males) with PAD were evaluated. Their clinical presentations were intermittent claudication in 51.4% of cases, rest pain in 16.8%, ulcers in 10.3%, and gangrene in 21.5%. Nine hundred ninety seven (66.8%) underwent OR and 495 (33.2%) ER as first intervention for PAD. No statistical differences were observed in terms of mortality in the 2 groups (OR versus ER, P = 1,000, P = 0.357, and P = 0.688 at 30 days, 2 years, and 5 years, respectively). The rate of minor amputations was significantly higher (P < 0.012, P < 0.002, and P < 0.007 at 30 days, 2 years, and 5 years, respectively) for ER group in any of the observed follow-up periods. Also, we have observed that OR and ER do not have any significant short-term and medium-term major amputation rate differences.
CONCLUSIONS: In our experience, the impact of ER does not significantly change short-term and mid-term major outcomes in patients with PAD.
摘要：
目的：本研究的目的是比较接受开放修复术（OR）或血管内修复术（ER）的外周动脉疾病（PAD）患者的短期和中期结局，包括基于严重程度和首次干预年份的分层。
方法：观察性回顾性单中心队列研究。
方法：我们评估了主要接受ER、OR,从2005年到2020年，在一个中心进行轻微和重大截肢。然后根据干预类型(ORvsER)对患者进行细分，并根据操作文件中报告的ICD-9代码和年度干预进行分层。死亡率,发生在30天的轻微和主要截肢率，首次干预后2年和5年被评估为主要结果，并在两个分层中的患者组之间进行比较。此外，分析这些结果的Kaplan-Maier(KM)曲线。
结果：评估了1492例PAD患者（67.0％为男性）。他们的临床表现为51.4%的间歇性跛行，休息疼痛16.8%，溃疡占10.3％，坏疽占21.5%。997（66.8％）接受OR和495（33.2％）ER作为PAD的首次干预。两组死亡率无统计学差异(ORvsER,p=1.000，p=0.357，p=0.688，30天，分别为2年和5年）。轻微截肢率明显较高(p<.012,p<.002,p<.007,30天,在任何观察到的随访期内，ER组分别为2年和5年）。此外，我们观察到OR和ER在短期和中期重大截肢率方面没有任何显著差异.
结论：根据我们的经验，ER的影响不会显著改变PAD患者的短期和中期主要结局.
方法：观察性回顾性单中心队列研究。
方法：我们评估了主要接受ER、OR,从2005年到2020年，在一个中心进行轻微和重大截肢。然后根据干预类型(ORvsER)对患者进行细分，并根据操作文件中报告的ICD-9代码和年度干预进行分层。死亡率,发生在30天的轻微和主要截肢率，首次干预后2年和5年被评估为主要结果，并在两个分层中的患者组之间进行比较。此外，分析这些结果的Kaplan-Maier(KM)曲线。
结果：评估了1492例PAD患者（67.0％为男性）。他们的临床表现为51.4%的间歇性跛行，休息疼痛16.8%，溃疡占10.3％，坏疽占21.5%。997（66.8％）接受OR和495（33.2％）ER作为PAD的首次干预。两组死亡率无统计学差异(ORvsER,p=1.000，p=0.357，p=0.688，30天，分别为2年和5年）。轻微截肢率明显较高(p<.012,p<.002,p<.007,30天,在任何观察到的随访期内，ER组分别为2年和5年）。此外，我们观察到OR和ER在短期和中期重大截肢率方面没有任何显著差异.
结论：根据我们的经验，ER的影响不会显著改变PAD患者的短期和中期主要结局.
