OBJECTIVE: The aim of this study was to determine whether endovascular or open revascularization provides an advantageous approach to symptomatic @entity3657 ( @entity3657 ) over the longer term. SUMMARY OF BACKGROUND DATA: The optimal revascularization strategy for symptomatic lower extremity @entity3657 is not established. METHODS: We evaluated amputation-free survival, overall survival, and relative rate of subsequent vascular intervention after endovascular or open lower extremity revascularization for propensity-score matched cohorts of Medicare beneficiaries with @entity3657 from 2006 through 2009. RESULTS: Among 14,685 eligible @entity1 , 5928 endovascular and 5928 open revascularization @entity1 were included in matched analysis. @entity1 undergoing endovascular repair had improved amputation-free survival compared with open repair at 30 days (7.4 vs 8.9%, P = 0.002). This benefit persisted over the long term: At 4 years, 49% of endovascular @entity1 had died or received major amputation compared with 54% of open @entity1 (P < 0.001). An endovascular procedure was associated with a risk-adjusted 16% decreased risk of amputation or @entity204 compared with open over the study period (hazard ratio: 0.84; 95% confidence interval, 0.79-0.89; P < 0.001). The amputation-free survival benefit associated with an endovascular revascularization was more pronounced in @entity1 with @entity712 or @entity741 than in those without (P = 0.021 for interaction term). The rate of subsequent intervention at 30 days was 7.4% greater for the endovascular vs the open revascularization cohort. At 4 years, this difference remained stable at 8.6%. CONCLUSIONS: Using population-based data, we demonstrate that an endovascular approach is associated with improved amputation-free survival over the long term with only a modest relative increased risk of subsequent intervention.

Endovascular Versus Open Revascularization for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure'] @entity3657 :: ('MESH:D058729', 'Disease') :: ['PAD', 'peripheral arterial disease'] @entity741 :: ('MESH:D017202', 'Disease') :: ['ischemic heart disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity3657 :: (MESH:D058729,Disease) :: ['Peripheral Arterial Disease']
