Endovascular Therapy, Open Surgical Bypass, and Conduit Types for Index Treatment of Claudication

Are endovascular interventions associated with a higher major amputation risk than open surgical bypass among patients with peripheral arterial disease with claudication?This cohort study involving 22 328 patients showed that endovascular procedures were associated with a lower rate of major amputation at 1 year compared with open surgical bypass. Among open bypass approaches, reversed great saphenous vein (GSV) conduits were associated with the lowest risk of major amputation.These findings suggest that patients with claudication may benefit most from endovascular-first intervention and subsequent open bypass using reversed GSV conduits.

Corresponding Author: Tiffany R. Bellomo, MD, Division of Vascular Surgery, Massachusetts General Hospital 15 Parkman St, WACC-440, Boston, MA 02114 (tbellomo@mgh.harvard.edu).

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