This analysis indicates significant benefits attributable to FLX compared with alternative compression therapies that can help reduce the notable economic burden of phlebolymphedema.
While previous studies have illustrated cost savings with adoption of FLX, US commercial health plans may also achieve tangible cost savings by expanding access to FLX for LE patients with comorbid CVI and multiple infections.
differed for AK popliteal (39% GSV, 61% PTFE) and BK popliteal targets (67% GSV, 33% PTFE). PTFE utilization varied and was inversely correlated with preoperative vein mapping among centers (Fig). Overall, patients undergoing FP bypass with PTFE were more likely to be claudicants and to have multiple medical comorbidities (Table). Perioperative outcomes were similar between groups, although FP bypass with GSV incurred higher rates of wound infection and reoperation (P < .01). At 1-year follow-up, GSV patients had higher graft occlusion-free survival (83% vs 78%; P < .001) and amputation-free survival (85% vs 80%; P < .001). On multivariable analyses, PTFE use was independently associated with graft occlusion (hazard ratio, 1.3; P ¼ .001) and amputation (hazard ratio, 1.4; P < .001). Bypass level (AK vs BK popliteal) was not a significant independent predictor of any 1-year outcomes.Conclusions: PTFE is frequently used in FP bypass, representing a majority of AK popliteal FP bypasses and one-third of BK popliteal FP bypasses. PTFE is associated with inferior 1-year outcomes independent of target artery level. GSV should be used for FP bypass whenever possible.
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