当前位置： SCI文献检索 > JOURNAL OF VASCULAR SURGERY期刊下所有文献 > Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass.

Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass.

Abstract：

OBJECTIVE:Hybrid procedures have gained momentum as less invasive operations that can potentially improve outcomes for patients. However, there is a paucity of data comparing hybrid procedures with traditional bypass. This study compares the perioperative outcomes of hybrid and bypass surgery for femoropopliteal (FP) revascularization. METHODS:The American College of Surgeons National Surgical Quality Improvement Program files (2012-2015) were reviewed, and three groups of patients undergoing isolated FP revascularization were identified by Current Procedural Terminology codes. All patients underwent femoral endarterectomy. The hybrid group (HYB) had a concomitant antegrade endovascular FP intervention and was compared with patients with concomitant FP bypass with vein (BPV) and FP bypass with nonvein graft (BPG). The demographics, comorbidities, and outcomes of the three groups were analyzed. The χ2 and analysis of variance tests with post hoc analysis were used. A multivariable logistic regression analysis was performed to identify predictors of readmission, reoperation, and mortality. RESULTS:There were 1480 patients in the analysis. Compared with patients undergoing BPV and BPG, patients in the HYB group tended to be older (P = .016) and were less likely to be smokers (P < .001). They had fewer infected wounds (P = .001) and were more likely to have American Society of Anesthesiologists score ≤3 (P = .01) and claudication (P < .01). HYB patients had significantly fewer bleeding transfusions (P = .01) and less overall morbidity (P < .001) compared with BPV and BPG patients. The three treatment groups did not differ in frequencies of mortality and major amputation. Among the groups, BPV was associated with the longest operating time (P < .001), whereas HYB had significantly shorter hospital stay (P < .001). HYB was also associated with significantly lower rates of reoperation (P = .017) and readmission (P = .007). On multivariable regression, patients undergoing BPG were at increased risk of readmission (odds ratio [OR], 1.48 [1.00-2.17]) compared with HYB. HYB surgery was associated with less morbidity compared with BPV (OR, 1.38 [1-1.9]) and BPG (OR, 1.77 [1.3-2.38]). CONCLUSIONS:Hybrid procedures have favorable perioperative outcomes compared with open bypass for FP revascularization. Additional research on the long-term outcomes of hybrid procedures is needed.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Jorshery SD,Skrip L,Sarac T,Ochoa Chaar CI

doi

10.1016/j.jvs.2018.01.058

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

1447-1454.e5

issue

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(18)30416-6

journal_volume

pub_type

杂志文章

在线工具

Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass.