Atherectomy during lower-extremity revascularization yields low rates of amputation, mortality, complications

Patients who underwent atherectomy during endovascular lower-extremity revascularization had lower rates of amputation, mortality and postprocedural complications compared with patients who did not receive atherectomy, according to data published in The American Journal of Cardiology.

Researchers analyzed participants of the Healthcare Cost and Utilization Project based on whether they did or did not undergo atherectomy at the time of endovascular lower-extremity revascularization.

The primary outcomes were in-hospital mortality and amputation. A secondary outcome was the composite of in-hospital mortality and periprocedural outcomes.

According to the findings, use of atherectomy was predictive of lower in-hospital mortality (OR = 0.46; 95% CI, 0.28-0.75), lower amputation (OR = 0.83; 95% CI, 0.71-0.97) and lower in-hospital mortality and periprocedural complications combined (OR = 0.79; 95% CI, 0.69-0.9).

In a propensity-matched cohort, the rate of amputation was 11.18% in the atherectomy group vs. 12.92% in the revascularization-only group (P = .029), in-hospital mortality was 0.71% vs. 1.53% (P = .001) and any complication was 13.24% vs. 16.09% (P = .001).

Atherectomy use was associated with higher hospitalization costs. The average cost of hospitalization in the group who received atherectomy was $24,790 compared with $22,635 for the group who underwent revascularization only (P < .001). – by Tracey Romero

Please see the full study for a list of all authors’ relevant financial disclosures.

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