{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:46:57Z","timestamp":1791877617538,"version":"4.3.4"},"reference-count":24,"publisher":"Hogrefe Publishing Group","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vasa"],"abstract":"<jats:p>Summary: Background: Evidence comparing endovascular therapy and open surgery for aorto-iliac occlusive disease remains limited, particularly for early complications, resource use, and sex-specific outcomes. Patients and methods: We conducted a retrospective nationwide cohort study using the 2023 German inpatient dataset. Adult hospitalisations with major endovascular or open aorto-iliac reconstructive procedures and arterial occlusive disease were included. Hospitalisations with aneurysm, dissection, or combined procedure codes were excluded. Outcomes included in-hospital mortality, myocardial infarction, ischaemic stroke, major adverse cardiovascular and cerebrovascular events (MACCE), complications, length of stay, and reimbursement. Adjusted estimates were obtained employing a doubly robust estimator using machine learning algorithms and were stratified by sex. Results: Among 2,710 hospitalisations, 1,923 (71.0%) underwent open surgery and 787 (29.0%) endovascular therapy; 41.3% involved women. Endovascular therapy was associated with lower adjusted risks of in-hospital mortality (RR .44, 95% CI .31\u2013.64), MACCE (RR .47, 95% CI .34\u2013.64), acute kidney injury (RR .38, 95% CI .29\u2013.50), major bleeding (RR .36, 95% CI .25\u2013.51), prolonged ventilation (RR .28, 95% CI .18\u2013.43), and SAEs (RR .46, 95% CI .33\u2013.65). Length of stay was shorter after endovascular therapy (\u22128.57 days, 95% CI \u20139.63 to \u22127.52), while reimbursement did not differ significantly. Sex-stratified estimates were more pronounced in men but exploratory without interaction testing. Conclusions: Endovascular therapy was associated with lower in-hospital morbidity and mortality and shorter hospital stay than open surgery, with similar reimbursement. Case-based data lacked longitudinal follow-up and detailed clinical, anatomical and treatment-selection information, limiting causal and patient-level interpretation.<\/jats:p>","DOI":"10.1024\/0301-1526\/a001314","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:03:01Z","timestamp":1791874981000},"source":"Crossref","is-referenced-by-count":0,"title":["Endovascular versus open repair for aortoiliac occlusive disease \u2013 nationwide in-hospital outcomes by sex"],"prefix":"10.1024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9841-3417","authenticated-orcid":true,"given":"Jonas","family":"Salm","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Medical center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"B\u00f6hme","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Medical center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8649-2055","authenticated-orcid":true,"given":"Elias","family":"Noory","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Medical center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8240-2270","authenticated-orcid":true,"given":"Lucas","family":"Bacmeister","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Medical center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"von zur M\u00fchlen","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Medical center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7542-1956","authenticated-orcid":true,"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Medical center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Zeller","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, University Heart Center Freiburg - Bad Krozingen, Medical center \u2013 University of Freiburg, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Kaier","sequence":"additional","affiliation":[{"name":"Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"101","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"c1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.12.037"},{"key":"c2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001251"},{"key":"c3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2023.08.067"},{"key":"c4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.12.035"},{"key":"c5","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2019.06.005"},{"key":"c6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.12.030"},{"key":"c7","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-0492"},{"key":"c8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.08.271"},{"key":"c9","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2022.05.007"},{"key":"c10","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.05.004"},{"key":"c11","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2025-106474"},{"key":"c12","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2025.07.041"},{"key":"c13","doi-asserted-by":"publisher","DOI":"10.1080\/07350015.2016.1166116"},{"key":"c14","doi-asserted-by":"publisher","DOI":"10.1583\/13-4242.1"},{"key":"c15","doi-asserted-by":"publisher","DOI":"10.1024\/0301-1526\/a001266"},{"key":"c16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.06.107"},{"key":"c17","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2021.10.040"},{"key":"c18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2024.03.437"},{"key":"c19","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.05.029"},{"key":"c20","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2020.08.139"},{"key":"c21","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1426"},{"key":"c22","doi-asserted-by":"publisher","DOI":"10.1177\/17085381231194152"},{"key":"c23","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2019.05.026"},{"key":"c24","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.320702"}],"container-title":["Vasa"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/econtent.hogrefe.com\/doi\/pdf\/10.1024\/0301-1526\/a001314","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:03:01Z","timestamp":1791874981000},"score":1,"resource":{"primary":{"URL":"https:\/\/econtent.hogrefe.com\/doi\/10.1024\/0301-1526\/a001314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":24,"alternative-id":["10.1024\/0301-1526\/a001314"],"URL":"https:\/\/doi.org\/10.1024\/0301-1526\/a001314","relation":{},"ISSN":["0301-1526","1664-2872"],"issn-type":[{"value":"0301-1526","type":"print"},{"value":"1664-2872","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"article-number":"0301-1526\/a001314"}}