{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:10:54Z","timestamp":1780488654048,"version":"3.54.1"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Lower\u2010extremity peripheral vascular interventions (PVIs) are increasingly used for treatment of peripheral artery disease. However, the relationship between hospital and operator PVI volume with in\u2010hospital major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) is not well established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We used the NCDR PVI (National Cardiovascular Data Registry) registry, including procedural data from April 1, 2014, to December 31, 2019, assessing in\u2010hospital MALEs and MACEs during hospitalization for PVI. Annualized PVI volumes were categorized on the basis of operator or site volume. Generalized linear mixed models assessed volume\u2013outcome relationships after adjustment of covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Between 2014 and 2019, 55\u2009785 PVI procedures were performed at 97 hospitals by 555 operators. Adjusted analysis showed no statistically significant association between hospital volume and MALEs (highest versus lowest volume: odds ratio, 0.91 [95% CI, 0.74\u20131.11];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.35) or hospital volume and MACEs (highest versus lowest volume: odds ratio, 1.23 [95% CI, 0.95\u20131.16];\n                      <jats:italic toggle=\"no\">P=<\/jats:italic>\n                      0.12). Notably, undergoing PVI with high\u2010volume operators was associated with lower odds of in\u2010hospital MALEs (odds ratio, 0.73 [95% CI, 0.55\u20130.97];\n                      <jats:italic toggle=\"no\">P=<\/jats:italic>\n                      0.03) and MACEs (odds ratio, 0.64 [95% CI, 0.44\u20130.95];\n                      <jats:italic toggle=\"no\">P=<\/jats:italic>\n                      0.03). Female sex and comorbidities including dyslipidemia, prior percutaneous coronary intervention, heart failure, and acute or chronic limb ischemia were associated with higher MALE risk. Older age and comorbidities including hypertension, dyslipidemia, end\u2010stage renal disease requiring dialysis, severe lung disease, prior myocardial infarction, heart failure, and acute limb ischemia were associated with greater MACE risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In contemporary practice, a significant relationship was observed between operator volume and adjusted PVI outcomes. Highest\u2010volume operators had lower rates of in\u2010hospital MALEs and MACEs compared with lowest\u2010volume operators.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.037165","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:50:39Z","timestamp":1761648639000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Procedural Volume and Outcomes in Lower\u2010Extremity Peripheral Vascular Interventions: Insights From the NCDR Peripheral Vascular Intervention Registry"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7288-7435","authenticated-orcid":false,"given":"Zainali","family":"Chunawala","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center","place":["Dallas, 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USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9651-3836","authenticated-orcid":false,"given":"Ambarish","family":"Pandey","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center","place":["Dallas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-4538","authenticated-orcid":false,"given":"Dharam J.","family":"Kumbhani","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center","place":["Dallas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheong Jun","family":"Lee","sequence":"additional","affiliation":[{"name":"NorthShore University Health System","place":["Evanston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Mishkel","sequence":"additional","affiliation":[{"name":"Endeavor Health Cardiovascular Institute","place":["Glenview, 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