Monitored Anesthesia Care is Associated with A Decrease in Morbidity After Endovascular Angioplasty in Aortoiliac Disease

Abstract Objective(s) There are few studies evaluating the association of anesthesia type with outcomes following endovascular angioplasty/stents for aortoiliac occlusive disease. The aim of our study was to evaluate the association of primary anesthesia type with post-procedural complications for endovascular angioplasty of aortoiliac occlusion. Design Retrospective cohort study. Setting Multi-institutional. Participants A total of 3110 patients undergoing endovascular angioplasty of aortoiliac occlusive disease with 1974 and 1136 who underwent monitored anesthesia care (MAC) and general anesthesia (GA) respectively. We used the American College of Surgeons - National Surgical Quality Improvement Program database for years 2012-2016. Interventions None. Measurements and Main Results The final analysis included 3110 patients, of which 63% received MAC and 37% received GA. The mean age was 64 years old among the GA group, 57.2% of which were male. Mean age among that MAC group was 65 years old, 55.8% of which were male. After adjusting for demographic factors and preoperative comorbidities, there was a statistically significant lower odds of postoperative complications (i.e., pulmonary complications, infection, intraoperative/postoperative transfusion, reoperation, and amputation) and shorter length of stay in the MAC group compared to the GA group (p Conclusions Although, larger observational studies and randomized control trials are needed to further evaluate the potential impact of MAC versus GA, MAC anesthesia should be considered for patients undergoing endovascular angioplasty for aortoiliac occlusion.