Ann Surg Treat Res.  2015 Dec;89(6):319-324. 10.4174/astr.2015.89.6.319.

National trends for the treatment of peripheral arterial disease in Korea between 2004 and 2013

• Park YY
• Joh JH
• Han SA
• Kim SH
• Cho S
• Park HC
• Ahn HJ

• KMID: 2148307
• DOI: http://doi.org/10.4174/astr.2015.89.6.319

Abstract

PURPOSE
Peripheral arterial disease (PAD) has been a major public health issue in the elderly. Advances in endovascular surgery have led to a substantial shift in the management of PAD. Although the nationwide trend of PAD treatment in the Western countries was reported, limited data have been available on this in Korea. This study examined the national trend in the treatment of PAD in Korea over the past decade.
METHODS
Health Insurance Review and Assessment Service data were used. We sought to analyze trends in the open and endovascular surgery for the treatment of PAD in Medicare beneficiaries between 2004 and 2013. We also analyzed trends in each types of surgery in the lower extremity. A linear-by-linear association was performed to determine the changes of PAD treatment for this period.
RESULTS
The rate of open surgery per 100,000 Medicare beneficiaries decreased significantly from 8 procedures in 2004 to 6 in 2013. At the same time, endovascular surgery increased from 23 procedures in 2004 to 59 in 2013. Endovascular surgery in the lower extremity increased more than twofold, while the open surgery decreased by 39%. The rate of balloon angioplasty among endovascular surgery was increased by almost threefold, while the bypass surgery using artificial graft decreased by half.
CONCLUSION
Endovascular surgery is now performed more commonly than open surgery for PAD treatment. Balloon angioplasty increased by almost threefold, while the bypass surgery using artificial graft decreased by about 50%.

Keyword

Trends; Peripheral arterial disease; Endovascular procedures; Balloon angioplasty

MeSH Terms

Aged
Angioplasty, Balloon
Endovascular Procedures
Humans
Insurance, Health
Korea*
Lower Extremity
Medicare
Peripheral Arterial Disease*
Public Health
Transplants

Figure

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  Fig. 1 Age distribution for the treatment of peripheral arterial disease.

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  Fig. 2 (A) Trends in total revascularization, endovascular and open surgery for peripheral arterial disease, 2004-2013. (B) Trends in total revascularization, endovascular and open surgery for peripheral arterial disease per 100,000 Medicare beneficiaries, 2004-2013. RR, risk ratio; CI, confidence interval.

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  Fig. 3 Trends in total revascularization, endovascular and open surgery for lower extremity arterial disease, 2004-2013. LE, lower extremity; RR, risk ratio; CI, confidence interval.

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  Fig. 4 (A) Trends in bypass with artificial graft or autologous vein and endarterectomy for the treatment of peripheral arterial disease, 2004-2013. (B) Trends in balloon angioplasty, stenting, and percutaneous for the treatment of peripheral arterial disease, 2004-2013. RR, risk ratio; CI, confidence interval.

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