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Wong KHF, Zucker BE, Wardle BG, et al. Systematic review and narrative synthesis of surveillance practices after endovascular intervention for lower limb peripheral arterial disease. J Vasc Surg. 2021;doi: 10.1016/j.jvs.2021.08.062.
Wong, K. H. F., Zucker, B. E., Wardle, B. G., Coughlin, P. A., Chaplin, K., Cheng, H. Y., Hinchliffe, R. J., Twine, C. P., & Ambler, G. K. (2021). Systematic review and narrative synthesis of surveillance practices after endovascular intervention for lower limb peripheral arterial disease. Journal of vascular surgery, . https://doi.org/10.1016/j.jvs.2021.08.062
Wong, Kitty H F, et al. "Systematic review and narrative synthesis of surveillance practices after endovascular intervention for lower limb peripheral arterial disease." Journal of vascular surgery vol. (2021). doi: https://doi.org/10.1016/j.jvs.2021.08.062
Wong KHF, Zucker BE, Wardle BG, Coughlin PA, Chaplin K, Cheng HY, Hinchliffe RJ, Twine CP, Ambler GK. Systematic review and narrative synthesis of surveillance practices after endovascular intervention for lower limb peripheral arterial disease. J Vasc Surg. 2021 Nov 24; doi: 10.1016/j.jvs.2021.08.062. Epub 2021 Nov 24. PMID: 34506892.
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J Vasc Surg. 2021 Nov 24; doi: 10.1016/j.jvs.2021.08.062. Epub 2021 Nov 24.

Systematic review and narrative synthesis of surveillance practices after endovascular intervention for lower limb peripheral arterial disease.

Journal of vascular surgery

Kitty H F Wong, Benjamin E Zucker, Bethany G Wardle, Patrick A Coughlin, Katherine Chaplin, Hung-Yuan Cheng, Robert J Hinchliffe, Christopher P Twine, Graeme K Ambler

Affiliations

  1. Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK; Department of Vascular Surgery, North Bristol NHS Trust, Bristol, UK.
  2. Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK; Department of Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
  3. Department of Vascular Surgery, North Bristol NHS Trust, Bristol, UK.
  4. Department of Vascular Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  5. Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK.
  6. Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol, Bristol, UK; Department of Vascular Surgery, North Bristol NHS Trust, Bristol, UK. Electronic address: [email protected].

PMID: 34506892 DOI: 10.1016/j.jvs.2021.08.062

Abstract

OBJECTIVE: The optimal timing and modality of surveillance after endovascular intervention for peripheral arterial disease is controversial, and no randomized trial to assess the value of peripheral endovascular intervention has ever been performed. The aim of this systematic review was to examine the practice of surveillance after peripheral endovascular intervention in randomized trials.

METHODS: We used the Medline, Embase, Cochrane Library, and WHO trial registry databases in this systematic review of the literature to capture surveillance strategies used in randomized trials comparing endovascular interventions. Surveillance protocols were assessed for completeness, modalities used, duration, and intensity.

RESULTS: Ninety-six different surveillance protocols were reported in 103 trials comparing endovascular interventions. Protocol specification was incomplete in 32% of trials. The majority of trials used multiple surveillance modalities (mean of 3.46 modalities), most commonly clinical examination (96%), ankle-brachial index (80%), duplex ultrasound examination (75%), and digital subtraction angiography (51%). Trials involving infrapopliteal lesions used more angiographic surveillance than trials with femoropopliteal lesions (P = .006). The median number of surveillance visits in the first 12 months after intervention was three and the mean surveillance duration was 21 months. Trials treating infrapopliteal vessels had a higher surveillance intensity compared with those treating femoropopliteal lesions in the first 12 months after endovascular intervention (mean 5 vs 3 surveillance visits; P = .017). Trials with drug-eluting devices had longer surveillance duration compared with those without (mean 26 vs 19 months; P = .020).

CONCLUSIONS: There is a high level of variation in the modality, duration, and intensity of surveillance protocols used in randomized trials comparing different types of peripheral endovascular arterial intervention. Further research is required to determine the value and impact of postprocedural surveillance on patient outcomes.

Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Keywords: Endovascular procedures; Peripheral arterial disease; Systematic review

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