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Temporal trends in peripheral arterial interventions: Observations from the blue cross blue shield of Michigan cardiovascular consortium (BMC2 PVI)
Author(s) -
Thomas Michael P.,
Jung Park Yeo,
Grey Scott,
Schreiber Theodore L.,
Gurm Hitinder S.,
Leffler Dale,
Davis Thomas P.,
Henke Peter,
Michael Grossman Paul
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26883
Subject(s) - medicine , atherectomy , claudication , angioplasty , critical limb ischemia , intermittent claudication , peripheral , cardiology , balloon , psychological intervention , popliteal artery , femoral artery , surgery , arterial disease , vascular disease , restenosis , stent , psychiatry
Objectives The aim is to examine trends in procedural indication, arterial beds treated, and device usage in peripheral arterial interventions (PVIs). Background There is little data on indication, vascular beds treated and devices utilized for peripheral arterial interventions. Methods We used data from 43 hospitals participating in the BMC2 VIC registry. PVIs were separated by year and divided by arterial segment. Lower extremity PVIs were subclassified as having been performed for claudication or critical limb ischemia (CLI). Yearly device usage was also included. A repeated measure ANOVA was used to determine trends. Results 44,650 PVIs were performed from 2006 to 2013. Renal interventions decreased from 18% of interventions in 2006 to 5.6% in 2013 ( P < 0.001) and femoral‐popliteal increased from 54.9% in 2006 to 64.5% in 2013 ( P < 0.001). No significant trend was seen for aorta‐iliac or below‐the‐knee interventions. 58.6% of PVIs were performed for claudication in 2006 and this decreased to 44.6% in 2013 ( P = 0.025). Indications for CLI were 24.1% in 2006 and 47.5% in 2013 ( P < 0.001). There were significant increases in the use of balloon angioplasty ( P = 0.029) and cutting/scoring balloons ( P < 0.001) while cryoballoon usage decreased ( P < 0.001). No significant changes were found with stenting, atherectomy, and laser. Conclusions There is a significant increase in patients presenting with CLI. Renal artery intervention rates are decreasing while femoral‐popliteal interventions are increasing. Additionally, balloon angioplasty and cutting/scoring balloon usage is increasing. © 2017 Wiley Periodicals, Inc.