Monitored Anesthesia Care Is Associated With a Decrease in Morbidity After Endovascular Angioplasty in Aortoiliac Disease.
OBJECTIVES
Few studies have evaluated the association between anesthesia type and outcomes after endovascular angioplasty/stents for aortoiliac occlusive disease. The aim of the present study was to evaluate the association between primary anesthesia type and postprocedural complications for endovascular angioplasty of aortoiliac occlusion.


DESIGN
Retrospective cohort study.


SETTING
Multi-institutional.


PARTICIPANTS
The study comprised 3,110 patients undergoing endovascular angioplasty of aortoiliac occlusive disease, with 1,974 and 1,136 patients who underwent monitored anesthesia care (MAC) and general anesthesia (GA), respectively. The American College of Surgeons National Surgical Quality Improvement Program database for the years 2012 to 2016 was used for the present study.


INTERVENTIONS
None.


MEASUREMENTS AND MAIN RESULTS
The final analysis included 3,110 patients, 63% of whom received MAC and 37% of whom received GA. The mean age was 64 years among the GA group, of whom 57.2% were male. The mean age among that MAC group was 65 years, 55.8% of whom were male. After adjusting for demographic factors and preoperative comorbidities, there was a statistically significant lower odds of postoperative complications (ie, pulmonary complications, infection, intraoperative/postoperative transfusion, reoperation, and amputation) and shorter length of stay in the MAC group compared with the GA group (p < 0.05).


CONCLUSIONS
Although larger observational studies and randomized controlled trials are needed to further evaluate the potential effect of MAC versus GA, MAC anesthesia should be considered for patients undergoing endovascular angioplasty for aortoiliac occlusion.
['Boulos|Nancy M|NM|', 'Burton|Brittany N|BN|', 'Carter|Devon|D|', 'Marmor|Rebecca A|RA|', 'Gabriel|Rodney A|RA|']
D000368:Aged D000768:Anesthesia, General D017130:Angioplasty D057510:Endovascular Procedures D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009017:Morbidity D012189:Retrospective Studies D012307:Risk Factors D016896:Treatment Outcome
endovascular angioplasty aortoiliac occlusion American College of Surgeons National Surgical Quality Improvement Program postoperative outcomes