title: Temporal trends in peripheral arterial interventions: Observations from the blue cross blue shield of michigan cardiovascular consortium (BMC2 PVI).
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Cardiovascular Medicine, Interventional Cardiology, University of Michigan, Ann Arbor, Michigan.|Division of Cardiovascular Medicine, Interventional Cardiology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Thomas
authors.affiliation: University of Michigan, Ann Arbor, Michigan.
authors.forename: Yeo
authors.initials: Y
authors.lastname: Jung Park
authors.affiliation: University of Michigan, Ann Arbor, Michigan.
authors.forename: Scott
authors.initials: S
authors.lastname: Grey
authors.affiliation: Division of Cardiovascular Medicine, Interventional Cardiology, Detroit Medical Center, Detroit, Michigan.
authors.forename: Theodore L
authors.initials: TL
authors.lastname: Schreiber
authors.affiliation: Division of Cardiovascular Medicine, Interventional Cardiology, University of Michigan, Ann Arbor, Michigan.|Division of Cardiovascular Medicine, Interventional Cardiology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors.forename: Hitinder S
authors.initials: HS
authors.lastname: Gurm
authors.affiliation: Division of Cardiovascular Medicine, Interventional Cardiology, Sparrow Health System, Lansing, Michigan.
authors.forename: Dale
authors.initials: D
authors.lastname: Leffler
authors.affiliation: Interventional Cardiology, Eastlake Cardiovascular, P.C, St Clair Shores, Michigan.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Davis
authors.affiliation: Vascular Surgery, University of Michigan, Ann Arbor, Michigan.|Vascular Surgery, VA Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors.forename: Peter
authors.initials: P
authors.lastname: Henke
authors.affiliation: Division of Cardiovascular Medicine, Interventional Cardiology, University of Michigan, Ann Arbor, Michigan.|Division of Cardiovascular Medicine, Interventional Cardiology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors.forename: Paul
authors.initials: P
authors.lastname: Michael Grossman
mesh_terms: D000368:Aged; D054598:Blue Cross Blue Shield Insurance Plans; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D009017:Morbidity / Q000639:trends; D058729:Peripheral Arterial Disease / Q000601:surgery*; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013525:Surgical Instruments / Q000706:statistics & numerical data*; D015996:Survival Rate / Q000639:trends; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000639:trends
keywords: claudication; critical limb ischemia; device usage; peripheral arterial disease; peripheral vascular interventions; temporal trends