Health-Related Quality of Life after Open and Endovascular Revascularization for Aortoiliac Occlusive Disease: A Prospective Cohort Study

IF 1.6 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2027-01-01 Epub Date: 2026-10-05 DOI:10.1016/j.avsg.2026.09.024

Francesco Squizzato, Elda Chiara Colacchio, Sabrina Menara, Mirko Menegolo, Franco Grego, Michele Piazza, Michele Antonello

{"title":"Health-Related Quality of Life after Open and Endovascular Revascularization for Aortoiliac Occlusive Disease: A Prospective Cohort Study","authors":"Francesco Squizzato, Elda Chiara Colacchio, Sabrina Menara, Mirko Menegolo, Franco Grego, Michele Piazza, Michele Antonello","doi":"10.1016/j.avsg.2026.09.024","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>To investigate the impact of open repair (OpR) and endovascular repair (ER) on health-related quality of life (HRQOL) in patients treated for aortoiliac occlusive disease (AIOD).</div></div><div><h3>Methods</h3><div>We conducted a single-center prospective observational cohort study on consecutive patients treated by OpR and ER for AIOD between January 2020 and July 2025. HRQOL was assessed using the 36-Item Short Form Health (SF-36) questionnaire at baseline, 1, 6, and 12 months. Physical component summary (PCS) and mental component summary (MCS) scores were compared between treatment groups using linear mixed-effects models with fixed effects for time, treatment, and their interaction. Linear regression models were used to assess factors associated with baseline HRQOL, while Firth's penalized logistic regression was used to evaluate factors associated with changes in HRQOL during follow up.</div></div><div><h3>Results</h3><div>Eighty-one patients were included: 20 (24.7%) underwent OpR and 61 (75.3%) ER for claudication (74.1%), rest pain (13.6%), or tissue loss (12.3%). No postoperative mortality occurred. Baseline PCS was associated with higher Rutherford class (<em>P</em> = 0.033) and TransAtlantic Inter-Society Consensus (TASC) lesion complexity (<em>P</em> = 0.02), while baseline MCS was associated with disease severity (<em>P</em> = 0.018) and comorbidities (<em>P</em> = 0.048). PCS improved significantly over time (<em>P</em> < 0.001), with a faster early improvement in the ER group (<em>P</em> for interaction = 0.005), especially within the first month from the procedure (<em>P</em> = 0.011). MCS also improved over time (<em>P</em> = 0.005), with no differences between groups. Early reintervention (<em>P</em> = 0.049 for PCS), late complications (<em>P</em> = 0.018 for PCS; <em>P</em> = 0.031 for MCS), chronic kidney disease (CKD) (<em>P</em> = 0.012 for PCS), coronary artery disease (CAD) (<em>P</em> = 0.014), and limb loss (<em>P</em> = 0.049 for PCS) were associated with reduced likelihood scores of HRQOL improvements at follow up.</div></div><div><h3>Conclusion</h3><div>Both OpR and ER were associated with significant improvements in HRQOL. ER provided faster early physical recovery, whereas mental health outcomes were comparable between treatment strategies. Patient characteristics and postoperative adverse events had a greater influence on HRQOL recovery than the revascularization strategy itself.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"134 ","pages":"Pages 416-427"},"PeriodicalIF":1.6000,"publicationDate":"2027-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0890509626006746","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/10/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Background

To investigate the impact of open repair (OpR) and endovascular repair (ER) on health-related quality of life (HRQOL) in patients treated for aortoiliac occlusive disease (AIOD).

Methods

We conducted a single-center prospective observational cohort study on consecutive patients treated by OpR and ER for AIOD between January 2020 and July 2025. HRQOL was assessed using the 36-Item Short Form Health (SF-36) questionnaire at baseline, 1, 6, and 12 months. Physical component summary (PCS) and mental component summary (MCS) scores were compared between treatment groups using linear mixed-effects models with fixed effects for time, treatment, and their interaction. Linear regression models were used to assess factors associated with baseline HRQOL, while Firth's penalized logistic regression was used to evaluate factors associated with changes in HRQOL during follow up.

Results

Eighty-one patients were included: 20 (24.7%) underwent OpR and 61 (75.3%) ER for claudication (74.1%), rest pain (13.6%), or tissue loss (12.3%). No postoperative mortality occurred. Baseline PCS was associated with higher Rutherford class (P = 0.033) and TransAtlantic Inter-Society Consensus (TASC) lesion complexity (P = 0.02), while baseline MCS was associated with disease severity (P = 0.018) and comorbidities (P = 0.048). PCS improved significantly over time (P < 0.001), with a faster early improvement in the ER group (P for interaction = 0.005), especially within the first month from the procedure (P = 0.011). MCS also improved over time (P = 0.005), with no differences between groups. Early reintervention (P = 0.049 for PCS), late complications (P = 0.018 for PCS; P = 0.031 for MCS), chronic kidney disease (CKD) (P = 0.012 for PCS), coronary artery disease (CAD) (P = 0.014), and limb loss (P = 0.049 for PCS) were associated with reduced likelihood scores of HRQOL improvements at follow up.

Conclusion

Both OpR and ER were associated with significant improvements in HRQOL. ER provided faster early physical recovery, whereas mental health outcomes were comparable between treatment strategies. Patient characteristics and postoperative adverse events had a greater influence on HRQOL recovery than the revascularization strategy itself.

查看原文本刊更多论文

主动脉髂闭塞疾病开放和血管内重建术后与健康相关的生活质量：一项前瞻性队列研究

目的：探讨开放（OR）和血管内修复（ER）对主动脉髂闭塞性疾病（AIOD）患者健康相关生活质量（HRQOL）的影响。方法：我们对2020年1月至2025年7月期间连续接受OR和ER治疗的AIOD患者进行了单中心前瞻性观察队列研究。在基线、1个月、6个月和12个月时，采用36项简短健康问卷（SF-36）评估HRQOL。采用时间、治疗及其相互作用固定效应的线性混合效应模型，比较治疗组间身体（PCS）和心理（MCS）成分总结得分。线性回归模型用于评估基线HRQOL的相关因素，而Firth的惩罚逻辑回归用于评估随访期间HRQOL变化的相关因素。结果：纳入81例患者：20例（24.7%）接受了手术，61例（75.3%）接受了ER手术，原因包括跛行（74.1%）、静息痛（13.6%）或组织丢失（12.3%）。无术后死亡发生。基线PCS与较高的卢瑟福分级（p = 0.033）和跨大西洋社会共识（TASC）病变复杂性（p = 0.02）相关，而基线MCS与疾病严重程度（p = 0.018）和合共病（p = 0.048）相关。随着时间的推移，PCS显著改善（p < 0.001）， ER组的早期改善更快（相互作用p = 0.005），特别是在手术后的第一个月内（p = 0.011）。MCS也随着时间的推移而改善（p = 0.005），组间无差异。早期再干预（PCS组p = 0.049）、晚期并发症（PCS组p = 0.018； MCS组p = 0.031）、慢性肾脏疾病（CKD）（PCS组p = 0.012）、冠状动脉疾病（CAD）（p = 0.014）和肢体丧失（PCS组p = 0.049）与随访时HRQOL改善的可能性评分降低相关。结论：OR和ER均与HRQOL的显著改善相关。急诊室提供了更快的早期身体恢复，而心理健康结果在治疗策略之间具有可比性。患者特征和术后不良事件对HRQOL恢复的影响大于血运重建策略本身。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence