{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T12:45:50Z","timestamp":1793450750661,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,7,16]]},"abstract":"<jats:sec id=\"jah39720-sec-0001\" sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Previous cross\u2010sectional studies have identified wide practice pattern variations in the use of peripheral vascular interventions (PVIs) for the treatment of claudication. However, there are limited data on longitudinal practice patterns. We aimed to describe the temporal trends and charges associated with PVI use for claudication over the past 12\u2009years in the United States.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah39720-sec-0002\" xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted a retrospective analysis using 100% Medicare fee\u2010for\u2010service claims data to identify all patients who underwent a PVI for claudication between January 2011 and December 2022. We evaluated the trends in utilization\u00a0and Medicare\u2010allowed charges of PVI according to anatomic level, procedure type, and intervention settings using generalized linear models. Multinomial logistic regressions were used to evaluate factors associated with different levels and types of PVI. We identified 599\u2009197 PVIs performed for claudication. The proportional use of tibial PVI increased 1.0% per year, and atherectomy increased by 1.6% per year over the study period. The proportion of PVIs performed in ambulatory surgical centers\/office\u2010based laboratories grew at 4% per year from 12.4% in 2011 to 55.7% in 2022. Total Medicare\u2010allowed charges increased by $11\u2009980\u2009035 USD\/year. Multinomial logistic regression identified significant associations between race and ethnicity and treatment setting with use of both atherectomy and tibial PVI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec id=\"jah39720-sec-0003\" xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The use of tibial PVI and atherectomy for the treatment of claudication has increased dramatically in in ambulatory surgical center\/office\u2010based laboratory settings, non\u2010White patients, and resulting in a significant increase in health care charges. There is a critical need to improve the delivery of value\u2010based care for the treatment of claudication.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.033463","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T10:37:43Z","timestamp":1720003063000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Trends and Factors Associated With Peripheral Vascular Interventions for the Treatment of Claudication From 2011 to 2022: A National Medicare Cohort Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4220-5939","authenticated-orcid":false,"given":"Chen","family":"Dun","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]},{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Stonko","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7007-1459","authenticated-orcid":false,"given":"Sanuja","family":"Bose","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8145-3209","authenticated-orcid":false,"given":"Alana C.","family":"Keegan","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]},{"name":"Sinai Hospital of Baltimore","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-524X","authenticated-orcid":false,"given":"Katherine M.","family":"McDermott","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kranti C.","family":"Rumalla","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"James H.","family":"Black","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7455-0369","authenticated-orcid":false,"given":"Corey A.","family":"Kalbaugh","sequence":"additional","affiliation":[{"name":"Indiana University School of Public Health\u2010 Bloomington","place":["Bloomington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin A.","family":"Makary","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]},{"name":"Johns Hopkins Carey Business School","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7638-1936","authenticated-orcid":false,"given":"Caitlin W.","family":"Hicks","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","unstructured":"Centers for Disease Control . About Peripheral Artery Disease (PAD). Accessed October 24 2023. https:\/\/www.cdc.gov\/heart\u2010disease\/about\/peripheral\u2010arterial\u2010disease.html#:~:text=Peripheral%20arterial%20disease%20(PAD)%20in This%20is%20called%20atherosclerosis."},{"key":"e_1_3_1_3_2","first-page":"365","article-title":"Clinical assessment of peripheral arterial disease in the office: what do the guidelines say?","volume":"35","author":"Tummala S","year":"2019","unstructured":"Tummala S, Scherbel D. Clinical assessment of peripheral arterial disease in the office: what do the guidelines say? Semin Interv Radiol. 2019;35:365\u2013377.","journal-title":"Semin Interv Radiol"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.04.012"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.19.21967"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.08.033"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.05.005"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.01.004"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.02.034"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.10.025"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.01.010"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2021.03.031"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481107700717"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.09.006"},{"key":"e_1_3_1_15_2","unstructured":"Research Data Assistance Center . Master Beneficiary Summary File (MBSF) base. Accessed October 24 2023. https:\/\/resdac.org\/cms\u2010data\/files\/mbsf\u2010base."},{"key":"e_1_3_1_16_2","unstructured":"National Bureau of Economic Research . Census Core\u2010Based Statistical Area (CBSA) to Federal Information Processing Series (FIPS) county crosswalk. Accessed October 24 2023. https:\/\/www.nber.org\/research\/data\/census\u2010core\u2010based\u2010statistical\u2010area\u2010cbsa\u2010federal\u2010information\u2010processing\u2010series\u2010fips\u2010county\u2010crosswalk."},{"key":"e_1_3_1_17_2","unstructured":"National Geographic . United States Regions. Accessed October 24 2023. https:\/\/education.nationalgeographic.org\/resource\/united\u2010states\u2010regions\/."},{"key":"e_1_3_1_18_2","unstructured":"Research Data Assistance Center . Claim place of service code. Accessed October 24 2023. https:\/\/resdac.org\/cms\u2010data\/variables\/claim\u2010place\u2010service\u2010code."},{"key":"e_1_3_1_19_2","unstructured":"Research Data Assistance Center . Line allowed charge amount. Accessed October 24 2023. https:\/\/resdac.org\/cms\u2010data\/variables\/line\u2010allowed\u2010charge\u2010amount#:~:text=The%20amount%20of%20allowed%20charges i.e.%2C%20deductible%20and%20coinsurance."},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.12.009"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0021-9509.17.09878-0"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.03.033"},{"key":"e_1_3_1_23_2","first-page":"655","article-title":"Atherectomy of the femoropopliteal artery: a systematic review and meta\u2010analysis of randomized controlled trials","volume":"55","author":"Diamantopoulos A","year":"2014","unstructured":"Diamantopoulos A, Katsanos K. Atherectomy of the femoropopliteal artery: a systematic review and meta\u2010analysis of randomized controlled trials. J Cardiovasc Surg. 2014;55:655\u2013665.","journal-title":"J Cardiovasc Surg"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.02.012"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006680.pub2"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.10.067"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574418772459"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90485-5"},{"issue":"73","key":"e_1_3_1_29_2","first-page":"214","article-title":"Appropriate use criteria for peripheral artery intervention","volume":"2019","author":"Bailey Steven R.","year":"2018","unstructured":"Bailey Steven R., Beckman Joshua A., Dao Timothy D., Misra Sanjay, Sobieszczyk Piotr S., White Christopher J., Wann L. Samuel, Bailey Steven R., Dao Timothy, Aronow Herbert D., Fazel Reza, Gornik Heather L., Gray Bruce H., Halperin Jonathan L., Hirsch Alan T., et\u00a0al. ACC\/AHA\/SCAI\/SIR\/SVM 2018 Appropriate use criteria for peripheral artery intervention. J Am Coll Cardiol 2019;73:214\u2013237.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.10.075"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.058998"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002219"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.focus.20190041"},{"issue":"72","key":"e_1_3_1_34_2","first-page":"26869","article-title":"2008: Annual payment rate updates, and policy changes; and hospital direct and indirect graduate medical education policy changes. Final rule","author":"Centers for Medicare & Medicaid Services (CMS), HHS. Medicare program; prospective payment system for long\u2010term care hospitals RY","year":"2007","unstructured":"Centers for Medicare & Medicaid Services (CMS), HHS. Medicare program; prospective payment system for long\u2010term care hospitals RY . 2008: Annual payment rate updates, and policy changes; and hospital direct and indirect graduate medical education policy changes. Final rule. Fed Regist. 2007;72:26869\u201327029.","journal-title":"Fed Regist"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.12.048"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2023.03.094"},{"key":"e_1_3_1_37_2","unstructured":"Anon . Society for vascular surgery|Choosing wisely. 2015. https:\/\/vascularspecialistonline.com\/choosing\u2010wisely\u2010a\u2010good\u2010start\u2010to\u2010explaining\u2010vascular\u2010best\u2010practices\/."}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.123.033463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T09:51:02Z","timestamp":1747302662000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.123.033463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,16]]},"references-count":36,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2024,7,16]]}},"alternative-id":["10.1161\/JAHA.123.033463"],"URL":"https:\/\/doi.org\/10.1161\/jaha.123.033463","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,16]]},"assertion":[{"value":"2024-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e033463"}}