Abstract 6194: Temporal Trends in Peripheral Arterial Interventions: Legs Up, Renals Down
Background: Peripheral arterial interventions (PVIs) are an expanding component of interventional cardiology practice. In addition, there has been an explosion in devices marketed for PVIs. However, little is known about the spectrum of arteries treated and devices utilized in contemporary PVI practice.
Objective: To identify temporal trends in arterial beds treated and devices in real-world practice.
Methods: The study sample included 5438 patients that underwent PVI on 8914 arterial segments (renal, iliac, femoral-popliteal (FP), and below the knee (BK)), in a regional, contemporary, multicenter registry (9 institutions) from January 2003 through December 2007.
Results: The mean age was 68 years, 43% were women, 72% had a history of coronary artery disease, 81% had hyperlipidemia, and 29% were active smokers. There was a temporal increase in FP and BK PVIs (p<0.0001 for both), and a significant temporal decline in renal artery interventions (p<0.0001). There was a 30% increase in the utilization balloon angioplasty as primary therapy (p<0.0001), and a 38% decline in the utilization of stents (p<0.0001). Adoption of other devices for PVI was seen over the course of the study period; atherectomy in 24%, laser in 9%, and cryoplasty balloon in 4% by 2007.
Conclusion: The increase in the number of PVIs performed in this registry is consistent with national trends. Specifically, there has been a boom in the number of FP and BK interventions, with associated increased use of atherectomy, laser and cryoplasty devices, while renal artery interventions have waned. These data suggest the need for randomized trials focused on the interventional management of FP and BK arterial disease.