Outcomes and management costs of peripheral arterial disease in France

Rivière, A. Bura; Bouée, S.; Laurendeau, C.; Torreton, E.; Gourmelen, J.; Thomas-Delecourt, Florence

doi:10.1016/j.jvs.2017.09.041

Cited by 13 publications

(9 citation statements)

References 17 publications

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“…It is also interesting to note that the percentage of revascularization is particularly high (68%). This is not surprising given the rates of endovascular and surgical revascularization of patients with PAD, which exceed 10% per year in France [16], whereas the data presented here concerns the history of revascularization without time limit.…”

Section: Discussionmentioning

confidence: 69%

Gender Differences in the Medical Treatment of Peripheral Artery Disease

Lanéelle

Sauvet

Guillaumat

et al. 2021

JCM

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Background/Objectives: Peripheral arterial disease is a frequent and severe disease with high cardiovascular morbidity and mortality. However, female patients appear to be undertreated. Objectives: The primary goal was to compare the prescription of optimal medical treatment (OMT) of peripheral arterial disease between women and men in primary health care. Material and methods: An observational retrospective study was based on the data collected from general practitioners (GP) office in Brittany. Results: The study included 100 patients, aged 71 ± 10 years old, with 24% of women. Compared to men, women received the OMT less frequently (29.2% vs. 53.9%, p = 0.038), especially after 75 years old. Antiplatelet therapy was largely prescribed (100%), statins less frequently (70.8% women vs. 85.5% men), and prescription of renin-angiotensin-aldosterone system inhibitors was still not optimal in the two genders (41.7% women vs. 61.9% men). Active smoking is important for both women and men (33% and 30% respectively). Conclusion: Optimal medical treatment of peripheral artery disease is insufficiently prescribed, especially in women in this region of France.

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Section: Discussionmentioning

confidence: 69%

Gender Differences in the Medical Treatment of Peripheral Artery Disease

Lanéelle

Sauvet

Guillaumat

et al. 2021

JCM

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“…Comparable results were found recently by others. 17,18,20 Moreover, the severe risk profile of CLI patients due to comorbidities such as chronic kidney disease and the lack of specific guidelines could have decreased the initiation of therapies by physicians in primary care before hospitalization. 21 Recently, a Swedish study showed that patients with PAD are less intensively treated than those with CVD.…”

Section: Discussionmentioning

confidence: 99%

Evolution of Major Amputation Risk in Patients Hospitalized in France for Critical Limb Ischemia: The COPART Registry

et al. 2020

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Over the past decade, improvements in medical treatment and revascularization techniques have been beneficial for patients with peripheral artery disease in the late stage of critical limb ischemia (CLI). We evaluated the putative reduction in the number of major amputees in the Cohorte des Patients ARTeriopathes (COPART) cohort over time. Patients were selected from this multicenter cohort, from 2006 to 2016, for CLI according to Trans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease II criteria. Patients included before and after 2011 were compared. Patients were followed for 1 year. Primary outcome was the rate of major amputations. Secondary outcomes were minor amputations, deaths from all causes, cardiovascular deaths; 989 patients were included, 489 before 2011 and 450 after 2011. There was a significant decrease in rates of major amputation after 2011 (17% vs 25%), confirmed in multivariate analysis (odds ratio [OR]: 1.5 [1.1-2.2]), an increase in revascularization, particularly distal angioplasty (OR: 2.7 [1.7-4.4]) and increased statin intake (OR: 1.6 [1.1-2.1]). For secondary outcomes, there was no significant difference. Limb prognosis of CLI patients has improved over the past decade, possibly due to more revascularizations, particularly distal ones, and increased statin use.

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“…Moreover, PAD prevalence is very likely underestimated as studies suggest that up to half of the patients suffering from PAD are asymptomatic [2][3][4]. With an aging population, PAD is a significant public health issue and a financial burden on the wider society [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Use of Arterial Doppler Waveform Classifications in Clinical Routine to Describe Lower Limb Flow

Guilcher

Lanéelle

Hoffmann

et al. 2021

JCM

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Background: Characterisation of arterial Doppler waveforms is a persistent problem and a source of confusion in clinical practice. Classifications have been proposed to address the problem but their efficacy in clinical practice is unknown. The aim of the present study was to compare the efficacy of the categorisation rate of Descotes and Cathignol, Spronk et al. and the simplified Saint-Bonnet classifications. Methods: This is a multicentre prospective study where 130 patients attending a vascular arterial ultrasound were enrolled and Doppler waveform acquisition was performed at the common femoral, the popliteal, and the distal arteries at both sides. Experienced vascular specialists categorized these waveforms according to the three classifications. Results: of 1033 Doppler waveforms, 793 (76.8%), 943 (91.3%) and 1014 (98.2%) waveforms could be categorized using Descotes and Cathignol, Spronk et al. and the simplified Saint-Bonnet classifications, respectively. Differences in categorisation between classifications were significant (Chi squared test, p < 0.0001). Of 19 waveforms uncategorized using the simplified Saint-Bonnet classification, 58% and 84% were not categorized using the Spronk et al. and Descotes and Cathignol classifications, respectively. Conclusions: The results of the present study suggest that the simplified Saint-Bonnet classification provides a superior categorisation rate when compared with Spronk et al. and Descotes and Cathignol classifications.

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Outcomes and management costs of peripheral arterial disease in France

Abstract: Mortality is elevated and cardiovascular events are frequent among French PAD patients. PAD drug treatment guidelines are not fully implemented in France.

Cited by 13 publications

References 17 publications

Gender Differences in the Medical Treatment of Peripheral Artery Disease

Gender Differences in the Medical Treatment of Peripheral Artery Disease

Evolution of Major Amputation Risk in Patients Hospitalized in France for Critical Limb Ischemia: The COPART Registry

Comparison of the Use of Arterial Doppler Waveform Classifications in Clinical Routine to Describe Lower Limb Flow

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