Temporal Trends in Peripheral Artery Interventions Analyzed in BMC2 PVI Registry
April 6, 2017—Findings from a study that aimed to examine trends in procedural indications, arterial beds treated, and device usage in peripheral artery interventions were published by Michael P. Thomas, MD, et al in Catheterization and Cardiovascular Interventions (CCI; 2017;89:726–734).
As summarized in CCI, the study included data from 43 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium Peripheral Vascular Interventions (BMC2 PVI) registry. Pulmonary vein isolations (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, the ANOVA test for thrombosis was used to determine trends.
The investigators concluded that there is a significant increase in patients presenting with CLI, as well as an increase in femoropopliteal interventions and the use of balloon angioplasty and cutting/scoring balloons, whereas renal artery intervention rates are decreasing.
There were 44,650 PVIs performed from 2006 to 2013. Renal interventions decreased from 18% of interventions in 2006 to 5.6% in 2013 (P < .001) and femoropopliteal interventions increased from 54.9% in 2006 to 64.5% in 2013 (P < .001). No significant trend was seen for aortoiliac or below-the-knee interventions.
In 2006, 58.6% of PVIs were performed for claudication; this decreased to 44.6% in 2013 (P = .025). Indications for CLI were 24.1% in 2006 and 47.5% in 2013 (P < .001). There were significant increases in the use of balloon angioplasty (P = .029) and cutting/scoring balloons (P < .001), while cryoballoon usage decreased (P < .001). No significant changes were found with stenting, atherectomy, or laser, reported the investigators in CCI.