Aug. 15 (UPI) -- Restoring blood flow from severe blockages in lower limbs has a better outcome and is a less expensive option than amputation, according to a study.
For the first time, researchers investigated the long-term outcomes and costs associated with treating major critical limb ischemia, which is the most severe form of peripheral artery disease. The findings were published Wednesday in the Journal of the American Heart Association.
Peripheral artery disease may result in ulcers on the leg, gangrene or the need for amputation.
"Many patients who are diagnosed with critical limb ischemia are told amputation is their only option," lead author Dr. Jihad Mustapha, an interventional cardiologist and critical limb ischemia specialist at Advanced Cardiac & Vascular Amputation Prevention Centers in Grand Rapids, Mich., said in a press release. "But amputation is associated with many poor outcomes, including shorter survival, depression and loss of independence."
Researchers studied Medicare records of 72,199 patients diagnosed with primary critical limb ischemia between 2010 and 2015. Approximately 75 percent of critical limb ischemia-related hospitalizations are paid through Medicare.
Of approximately 36.5 million Medicare beneficiaries enrolled in 2011, 116,031 received a primary critical limb ischemia.
An estimated 29 percent of patients diagnosed with the disease will die or have an amputation performed within the first year, according to the study. In addition, many underwent several revascularization procedures over the median 3.5-year survival study period.
The survival rate for endovascular revascularization, which is angioplasty with or without stenting, was 38 percent. That compared with 40 percent with surgical revascularization, which is bypassing blocked vessels with vein grafts, and 23 percent for major amputation.
The average annual costs, including follow-up, were $49,700 for endovascular revascularization, $49,200 for surgical revascularization and $55,700 for amputation.
"It's important that people know that amputation is not the only solution, so always get a second opinion," Mustapha said.
In an accompanying editorial, Drs. Stephen Waldo and Javier Valle noted the significant clinical and financial burden of the disease.
"Considerable efforts are still needed to raise disease awareness and establish data that can guide further medical and procedural management given the critical importance of limb ischemia," they wrote.