Lower Extremity Revascularization Among Patients With Premature Peripheral Artery Disease Compared To Patients At The Common Age Of Presentation In The Vascular Quality Initiative

Abstract

<h3>INTRODUCTION AND OBJECTIVES</h3> Premature peripheral artery disease (PAD) (age ≤50) is associated with poor outcomes following lower extremity revascularization (LER). However, the specific characteristics and outcomes compared to patients at the common age of presentation have not been examined. The aim of this study is to compare patients with premature PAD to patients with the common age of presentation undergoing LER. <h3>METHODS</h3> All LER procedures (open and endovascular) in the VQI were reviewed. A histogram of patient age at intervention for de novo disease (no prior LER) was used to define the common age of presentation. Characteristics and outcomes of patients with premature PAD were compared to patients treated at the common age of presentation.Figure 1 <h3>RESULTS</h3> The common age of presentation was defined as 60-80 years based on the histogram. (Figure) Patients with premature PAD were more likely to be female, African American, and Hispanic compared to patients at the common age of presentation. (Table) Patients with premature PAD also had higher rates of insulin-dependent diabetes, smoking, and dialysis, but less severe disease based on TASC classification. These differences in characteristics were more pronounced in patients with CLTI. Logistic regression demonstrated that premature PAD was independently associated with major adverse limb events (MALEs) at one-year for claudication (OR:1.68[1.38-2.04]) and CLTI (OR:1.31[1.13-1.51]) compared to patients 60-80-year-old. <h3>CONCLUSIONS</h3> Patients with premature PAD have significant differences in characteristics compared to patients treated at the common age of presentation. Despite having less severe disease burden, patients with premature PAD have worse one-year MALEs.