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CC BY 4.0 · The Arab Journal of Interventional Radiology
DOI: 10.1055/s-0044-1788933
Original Article

Catheter-Directed Therapies for Deep Vein Thrombosis and Pulmonary Embolism: Nationwide Trends in Medicare Part B Patients from 2015 to 2021

Alex G. Thomas 
1   University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States
,
Osman S. Ahmed
2   Department of Radiology, Vascular and Interventional Radiology, University of Chicago, Chicago, Illinois, United States
,
Qian Yu
2   Department of Radiology, Vascular and Interventional Radiology, University of Chicago, Chicago, Illinois, United States
,
Divya Kumari
2   Department of Radiology, Vascular and Interventional Radiology, University of Chicago, Chicago, Illinois, United States
,
Mikin V. Patel
2   Department of Radiology, Vascular and Interventional Radiology, University of Chicago, Chicago, Illinois, United States
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Abstract

Background Nationwide trends in the utilization of catheter-directed therapies for deep vein thrombosis and pulmonary embolism in the Medicare population are essential as they represent a major health care challenge. The annual incidence and mortality with venous thromboembolism are around 900,000 and 60,000 to 100,000 patients, respectively, in the United States.

Methods Data were acquired from the Data.CMS.gov website on Physician/Supplier Procedure Summary with a list of Medicare Part B fee-for-service claims from 2015 to 2021. Current Procedural Terminology codes 37187 (percutaneous venous mechanical thrombectomy) and 37212 (thrombolytic venous therapy) were queried for deep vein thrombosis. Similarly, Current Procedural Terminology codes 37184 (percutaneous arterial mechanical thrombectomy) and 37211 (thrombolytic arterial therapy) were queried for pulmonary embolism. Annual procedure counts, site of service, and self-reported specialty of the operator were recorded.

Results Overall, there was a trend toward increasing utilization of thrombectomy and decreasing utilization of thrombolysis procedures for both deep vein thrombosis and pulmonary embolism. Radiologists performed the majority of the catheter-directed therapy interventions for deep vein thrombosis, while radiologists and surgeons performed a similar number of catheter-directed therapy procedures for pulmonary embolism. Cardiologists were third in the catheter-directed therapy procedure count for both deep vein thrombosis and pulmonary embolism.

Conclusion An analysis of nationwide trends from 2015 to 2021 suggests increasing utilization of thrombectomy starting in 2020 when compared to thrombolysis for catheter-directed therapies for both deep vein thrombosis and pulmonary embolism procedures. Newer thrombectomy technologies may be one of the drivers of this shift from thrombolysis to thrombectomy.

Keywords

catheter-directed therapy - deep vein thrombosis - pulmonary embolism - thrombectomy - thrombolysis

Data Availability Statement

The datasets generated and/or analyzed during the current study are available in the Data.CMS.gov repository, the Medicare database website Physician/Supplier Procedure Summary - Centers for Medicare & Medicaid Services Data (cms.gov). The authors take complete responsibility for the accuracy of the data analysis.


Authors' Contribution

A.G.T. contributed to the design of the project and data acquisition, drafted and revised the manuscript, and gave final approval of the submitted version. O.S.A. contributed to the conception and design of the project, supervision of data acquisition and data analysis, critical revision of the manuscript, and final approval of the submitted version. Q.Y. and D.K. contributed to critical revision of the manuscript and final approval of the submitted version. M.V.P. contributed to conception and design of the project, supervision of data acquisition and data analysis, critical revision of the manuscript, and final approval of the submitted version.




Publication History

Article published online:
18 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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