| Summary: | Objectives: Traditional outcomes after vascular intervention include vessel patency, limb salvage rates and mortality but correlate poorly with functional goals. Patent-oriented outcomes are patient-reported functional outcomes. The aim of this study is divided into 2 complementary parts: Part A: To define patient-oriented outcomes by performing a patient survey. Part B: Systematic review of treatment options in lower limb CLI according to patient-oriented outcomes, defined by part A.
Methods: Part A: CLI patients ranked 10 outcomes according to importance. Part B: A systematic review of randomised control trials assessing angioplasty, stenting and bypass surgery according to patient-oriented outcomes.
Results: Part A: A patient survery indicates that QOL, symptom relief, living status, amputation-free survival and mobility should be considered patient-oriented outcomes. Patients place little importance is placed on vessel patency and reintervention. Part B: 6 RCTs involving 1166 patients assessed QOL, symptom relief, and amputation-free survival following vascular intervention. There is no significant difference in QOL between bypass surgery and angioplasty. There is no difference in symptom relief between sirolimus-eluding stents and angioplasty. Bare-metal stents and angioplasty were not significantly different in providing symptom relief. There was poor correlation between traditional outcomes and patient-oriented outcomes.
Conclusion: There is no evidence supporting a single superior treatment between angioplasty, stenting and bypass surgery when assessed by patient-oriented outcomes.
|
|---|
