Semin intervent Radiol 2023; 40(02): 193-196
DOI: 10.1055/s-0043-57265
Review Article

Peripheral Arterial Disease Treatment in the Non-Hospital Setting

Bret N. Wiechmann
1   Vascular and Interventional Physicians, Gainesville, Florida
› Author Affiliations

Abstract

Treatment of peripheral artery disease (PAD) has undergone a progressive shift toward less invasive, endovascular options within the last three decades. For PAD patients, the benefits of this shift are numerous and include less periprocedural pain, decreased blood loss, shorter recovery times, and fewer missed workdays. Commonly, patient-reported outcomes are very positive with this “endovascular first” strategy and the number of open surgical procedures for various stages of PAD has declined steadily over the last 20 years. Coincident with this trend is the move toward “ambulatory” lower extremity arterial intervention (LEAI) in the hospital outpatient “same-day” department. The next logical extension was then performing LEAI in a true physician office-based lab (OBL), ambulatory surgical center (ASC), or “non-hospital setting.” This article examines these trends and the concept that the OBL/ASC provides a safe, alternative site of service for PAD patients requiring LEAI.



Publication History

Article published online:
16 June 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Goodney PP, Beck AW, Nagle J, Welch HG, Zwolak RM. National trends in lower extremity bypass surgery, endovascular interventions, and major amputations. J Vasc Surg 2009; 50 (01) 54-60
  • 2 Lin PH, Yang KH, Kollmeyer KR. et al. Treatment outcomes and lessons learned from 5134 cases of outpatient office-based endovascular procedures in a vascular surgical practice. Vascular 2017; 25 (02) 115-122
  • 3 Mesbah Oskui P, Kloner RA, Burstein S. et al. The safety and efficacy of peripheral vascular procedures performed in the outpatient setting. J Invasive Cardiol 2015; 27 (05) 243-249
  • 4 D'Souza SM, Stout CL, Krol E, Dexter DJ, Ahanchi SS, Panneton JM. Outpatient Endovascular Tibial Artery Intervention in an office-based setting is a safe and effective as in a hospital setting. J Endovasc Ther 2018; 25 (06) 666-672
  • 5 Turley RS, Mi X, Qualls LG. et al. The effect of CLTInical care location on CLTInical outcomes after peripheral vascular intervention in Medicare beneficiaries. JACC Cardiovasc Interv 2017; 10 (11) 1161-1171
  • 6 Porter ME. Value-based health care delivery. Ann Surg 2008; 248 (04) 503-509
  • 7 Ansari A, Shah MA, Shah MA, Ansari Z. Safety of day-case endovascular interventions for peripheral arterial disease in a rural, underserved area. Ther Adv Cardiovasc Dis 2020; 14: 1753944720948651
  • 8 Mazzolini C. . Accessed April 8, 2023 at: https://www.medicaleconomics.com/view/how-reclaim-physician-autonomy; March 24 2020
  • 9 Jain K, Munn J, Rummel MC, Johnston D, Longton C. Office-based endovascular suite is safe for most procedures. J Vasc Surg 2014; 59 (01) 186-191
  • 10 Ahn SS, Tahara RW, Jones LE, Carr JG, Blebea J. Preliminary results of the Outpatient Endovascular and Interventional Society National Registry. J Endovasc Ther 2020; 27 (06) 956-963
  • 11 Munnich EL, Richards MR. Long-run growth of ambulatory surgery centers 1990-2015 and Medicare payment policy. Health Serv Res 2022; 57 (01) 66-71
  • 12 Schramm KM, DeWitt PE, Dybul S. et al. Recent trends in clinical setting and provider specialty for endovascular peripheral artery disease interventions for the Medicare population. J Vasc Interv Radiol 2020; 31 (04) 614-621.e2
  • 13 Peripheral Vascular Devices. Medtech 360 Market Insights US 2021. Millennium Research Group; 2020
  • 14 Henry AJ, Hevelone ND, Belkin M, Nguyen LL. Socioeconomic and hospital-related predictors of amputation for critical limb ischemia. J Vasc Surg 2011; 53 (02) 330-9.e1
  • 15 OEIS National Registry. . (2023). OEIS National Registry Clinical Summary Report. Accessed September 21, 2022 at: https://www.syncronyedc.com/#/reporting
  • 16 Wiechmann BN. Ambulatory Treatment of Critical Limb Ischemia (CLTI). International Symposium on Endovascular Therapy. Hollywood, FL. January 2022