Upchurch Gilbert R, Dimick Justin B, Wainess Reid M, Eliason Jonathan L, Henke Peter K, Cowan John A, Eagleton Matthew J, Srivastava Sunita D, Stanley James C
Surgical Outcomes Research Team (SORT), Section of Vascular Surgery, University of Michigan Medical Center, Ann Arbor, MI 48109-0329, USA.
Surgery. 2004 Oct;136(4):812-8. doi: 10.1016/j.surg.2004.06.019.
The objective of the current study was to characterize temporal trends in the treatment of aorto-iliac occlusive disease (AIOD) and the impact of the introduction of less invasive therapy on overall intervention rates.
Patients with diagnostic codes for AIOD, and procedure codes for aortofemoral bypass (AFB) or iliac artery angioplasty and stenting were selected from the Nationwide Inpatient Sample for 1996 to 2000. Utilization rates of both intervention types were determined. Outcome variables including in-hospital mortality and duration of stay were assessed.
The rate of iliac artery angioplasty and stenting increased 850%, from 0.4 to 3.4 cases per 100,000 adults (P <.001). The rate of AFB declined 15.5%, from 5.8 to 4.9 cases per 100,000 adults (P <.005). Older age, white race, and higher-income patients were more likely to undergo angioplasty and stenting. AFB had a higher mortality rate, longer duration of stay, and higher hospital charges compared to angioplasty and stenting.
Iliac artery angioplasty and stenting has rapidly gained a large market share in the treatment of AIOD. Acceptable clinical outcomes have likely lowered the threshold for treatment and contributed to the rapid diffusion of this technology for the treatment of AIOD.
本研究的目的是描述主-髂动脉闭塞性疾病（AIOD）治疗的时间趋势以及引入侵入性较小的治疗方法对总体干预率的影响。
从1996年至2000年的全国住院患者样本中选取具有AIOD诊断代码以及主动脉-股动脉旁路移植术（AFB）或髂动脉血管成形术及支架置入术程序代码的患者。确定两种干预类型的使用率。评估包括住院死亡率和住院时间在内的结果变量。
髂动脉血管成形术及支架置入术的发生率增加了850%，从每10万名成年人0.4例增至3.4例（P<.001）。AFB的发生率下降了15.5%，从每10万名成年人5.8例降至4.9例（P<.005）。年龄较大、白种人和高收入患者更有可能接受血管成形术及支架置入术。与血管成形术及支架置入术相比，AFB的死亡率更高、住院时间更长且住院费用更高。
髂动脉血管成形术及支架置入术在AIOD治疗中迅速获得了很大的市场份额。可接受的临床结果可能降低了治疗门槛，并促进了该技术在AIOD治疗中的迅速推广。
