Temporal trends in peripheral arterial interventions: Observations from the blue cross blue shield of Michigan cardiovascular consortium (BMC2 PVI)

Thomas, Michael P.; Park, Yeo Jung; Grey, Scott F.; Schreiber, Theodore; Gurm, Hitinder S.; Leffler, Dale; Davis, Thomas P.; Henke, Peter K.; Grossman, Paul

doi:10.1002/ccd.26883

Cited by 13 publications

(6 citation statements)

References 13 publications

(8 reference statements)

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“…Lower GFR, hypertension, diabetes, prior heart failure, anemia, and CLI were all independently associated with AKI. Similarly, Grossman et al using data from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium, 26 and Prasad et al 1 using clinical administrative data from the National Inpatient Sample, demonstrated a strong association between CLI and risk of AKI. These studies have further mirrored the coronary revascularization literature in that the occurrence of AKI following endovascular therapy is significantly associated with the need for renal replacement therapy and mortality.…”

Section: Discussionmentioning

confidence: 89%

Use of iso‐osmolar contrast media during endovascular revascularization is associated with a lower incidence of major adverse renal, cardiac, or limb events

Prasad

Amin

Ryan

et al. 2021

Cathet Cardio Intervent

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Objective: We examined the association of iso-osmolar contrast media (IOCM) versus low-osmolar contrast media (LOCM) with major adverse renal, cardiovascular, or limb events in patients at high-risk of acute kidney injury (AKI) undergoing peripheral endovascular procedures.Background: Procedural characteristics including iodinated contrast type and volume have been associated with adverse renal and cardiovascular outcomes in patients undergoing angiographic interventions.Methods: Patients at high-risk of AKI, undergoing peripheral endovascular procedures were identified using the Premier Healthcare Database and separated into claudication and critical limb ischemia (CLI) cohorts. For each cohort, we compared IOCM versus LOCM for the primary endpoint of MARCE (major adverse renal or cardiovascular events) and secondary endpoints of major adverse renal events (MARE) and major adverse renal and limb events (MARLE). These outcomes were captured within the indexed hospitalization via adjusted multivariable regression analyses.Results: Two procedure-based cohorts of high-risk patients were formed: claudication (N = 11,976) and CLI (N = 8713). Use of IOCM was associated with a significant absolute risk reduction (ARR) of 2.2% (p < 0.0001) for MARCE overall and in each cohort (claudication, 1.8%, p = 0.0070; CLI, 2.7%, p = 0.0054). The incidence of MARE and MARLE in the overall cohort was also lower with the use of IOCM: MARE (ARR = 1.4%, p = 0.0072) and MARLE (ARR = 2.0%, p = 0.0043).Conclusions: Using IOCM versus LOCM in patients at high-risk of adverse renal events undergoing peripheral endovascular procedures was independently associated with lower risk of MARCE, MARE, and MARLE.

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Section: Discussionmentioning

confidence: 89%

Use of iso‐osmolar contrast media during endovascular revascularization is associated with a lower incidence of major adverse renal, cardiac, or limb events

Prasad

Amin

Ryan

et al. 2021

Cathet Cardio Intervent

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“…Despite a lack of RCT data and comparative studies, particularly in Ao‐I vessels, specialty balloon usage has dramatically increased over time in lower extremity EVT. In the Blue Cross Blue Shield of Michigan Cardiovascular Consortium PVI Registry of 44,650 prospectively enrolled patients, specialty balloon (namely cutting balloon) utilization increased from 1.8% in 2006 to 15.1% in 2013 ( p trend < .001) 18 . Available outcomes data are observational and focus on immediate technical success and patency.…”

Section: Devicesmentioning

confidence: 99%

SCAI guidelines on device selection in Aorto‐Iliac arterial interventions

Feldman

Armstrong

Aronow

et al. 2020

Cathet Cardio Intervent

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Aorto-iliac (Ao-I) disease is quite prevalent and leads to significant limitation in functional status and quality of life. Advances in endovascular therapy (EVT) techniques in the last 25 years, low risk of periprocedural complications and excellent long-term patency have made it possible to treat most symptomatic patients with Ao-I disease using an endovascular-first rather than a surgical approach in addition to guidelines-directed medical therapy. The approach to intra-procedural assessment of Ao-I lesions has evolved over time to include pressure gradient measurement and intravascular imaging. In 2017, the Society for Cardiovascular Angiography and Interventions (SCAI) published an update to the Appropriate Use Criteria (AUC) for EVT in the Ao-I, femoral-popliteal (FP), infra-popliteal and renal arterial circulations. 1 In 2018, a multi-societal AUC document for EVT was released by the

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“…53 In a study of 44,650 PVIs performed in 43 hospitals from 2006 to 2013, a significant temporal trend was observed for PVI indications in treating CLI. 54 In 2006, 24.1% of the 1,677 PVIs were performed for CLI while 47.5% of the 9,185 PVIs were performed for CLI in 2013. The largest increase in PVI performed was for femoropopliteal disease, with no significant trend in aortoiliac or below-the-knee pathology.…”

Section: Outcomes and Mortalitymentioning

confidence: 99%

Using the epidemiology of critical limb ischemia to estimate the number of patients amenable to endovascular therapy

2019

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Critical limb ischemia represents the advanced stage of peripheral artery disease, a health problem with increasing prevalence. Critical limb ischemia is associated with significant mortality, limb loss, pain, and diminished health-related quality of life. Public awareness and early diagnosis are necessary for an effective treatment with early risk factor modification, smoking cessation, and exercise therapy. Herein, we present an overview of the epidemiology as well as the clinical stages of the disease, and estimate that there are 6.5 million patients with critical limb ischemia in the US, Europe, and Japan based on global population-based studies. At least 75% of these patients, accounting for approximately 4.8 million patients, are amenable to endovascular therapy.

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Temporal trends in peripheral arterial interventions: Observations from the blue cross blue shield of Michigan cardiovascular consortium (BMC2 PVI)

Abstract: 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.

Cited by 13 publications

References 13 publications

Use of iso‐osmolar contrast media during endovascular revascularization is associated with a lower incidence of major adverse renal, cardiac, or limb events

Use of iso‐osmolar contrast media during endovascular revascularization is associated with a lower incidence of major adverse renal, cardiac, or limb events

SCAI guidelines on device selection in Aorto‐Iliac arterial interventions

Using the epidemiology of critical limb ischemia to estimate the number of patients amenable to endovascular therapy

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