Intravascular ultrasound in lower extremity peripheral vascular interventions: Variation in utilization and impact on in-hospital outcomes from the nationwide inpatient sample (2006-2011)

Sidakpal S. Panaich, Shilpkumar Arora, Nilay Patel, Nileshkumar J. Patel, Chirag Savani, Achint Patel, Badal Thakkar, Vikas Singh, Samir Patel, Nish Patel, Kanishk Agnihotri, Parth Bhatt, Abhishek Deshmukh, Vishal Gupta, Ramak R. Attaran, Carlos I. Mena, Cindy L. Grines, Michael Cleman, John K. Forrest, Apurva O. Badheka

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To examine the impact of intravascular ultrasound (IVUS) utilization during lower limb endovascular interventions as regards postprocedural complications and amputation. Methods: The study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database between the years 2006 and 2011. Peripheral endovascular interventions were identified using appropriate ICD-9 procedure codes. Two-level hierarchical multivariate mixed models were created. The co-primary outcomes were in-hospital mortality and amputation; the secondary outcome was postprocedural complications. Model results are given as the odds ratio (OR) and 95% confidence interval (CI). Hospitalization costs were also assessed. Results: Overall, among the 92,714 patients extracted from the database during the observation period, IVUS was used in 1299 (1.4%) patients. IVUS utilization during lower extremity peripheral vascular procedures was independently predictive of a lower rate of postprocedural complications (OR 0.80, 95% CI 0.66 to 0.99, p=0.037) as well as lower amputation rates (OR 0.59, 95% CI 0.45 to 0.77, p<0.001) without any significant impact on in-hospital mortality. Multivariate analysis also revealed IVUS utilization to be predictive of a nonsignificant increase in hospitalization costs ($1333, 95% CI -$167 to +$2833, p=0.082). Conclusion: IVUS use during lower limb endovascular interventions is predictive of lower postprocedural complication and amputation rates with a nonsignificant increase in hospitalization costs.

Original languageEnglish (US)
Pages (from-to)65-75
Number of pages11
JournalJournal of Endovascular Therapy
Volume23
Issue number1
DOIs
StatePublished - Feb 2016
Externally publishedYes

Keywords

  • Amputation
  • Angioplasty
  • Complications
  • Cost analysis
  • Intravascular ultrasound
  • Mortality
  • Peripheral vascular interventions
  • Resource utilization
  • Stents
  • Ultrasound

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Intravascular ultrasound in lower extremity peripheral vascular interventions: Variation in utilization and impact on in-hospital outcomes from the nationwide inpatient sample (2006-2011)'. Together they form a unique fingerprint.

Cite this