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Eur J Trauma Emerg Surg · Feb 2022
Endovascular repair is a feasible option for superficial femoral artery injuries: a comparative effectiveness analysis.
- Sean Degmetich, Megan Brenner, Matthew Firek, Bishoy Zakhary, Bruno C Coimbra, and Raul Coimbra.
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, 26520 Cactus Ave., CPC Building, Suite 102-5, Moreno Valley, CA, 92555, USA.
- Eur J Trauma Emerg Surg. 2022 Feb 1; 48 (1): 321328321-328.
PurposeTo compare outcomes between open (OR) and endovascular repair following superficial femoral artery (SFA) injuries.MethodsThis is a cross-sectional study querying the 2012-2014 National Inpatient Sample for SFA injuries. Patients were grouped into OR and stent-graft placement (SGP). Primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (HLOS), fasciotomy and amputation rate, and cost. Wilcoxon rank-sum, Kruskal-Wallis, Chi-squared test with Bonferroni adjustment were used as appropriate; p < 0.05 was significant.Results255 Patients were identified. Mean age was 34.6 years and majority were males. OR was performed in 82.7%. Overall mortality rate was 3.7%. Median HLOS was 8 days. Fasciotomies were performed in 31% and lower limb amputations in 3.7%. Males more often underwent OR (89.0% vs. 73.1%, p < 0.01). SGP patients were significantly older (44.9 vs. 32.5 years; p < 0.01), and with Medicare insurance (20.5% vs. 6.5%; p < 0.01. Mortality, HLOS, and hospitalization cost were not significantly different. OR patients had higher rate of fasciotomy (35.4% vs. 15.4%; p < 0.01).ConclusionsEndovascular management is not inferior to OR following SFA injuries and both carry a low amputation rate. OR is associated with a higher fasciotomy rate. Endovascular repair should be considered when technically feasible.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.
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