The use of intravascular ultrasound (IVUS) for the treatment of claudication doubled over a four-year period but there was “no clear relationship between IVUS use and improved patient outcomes,” a recently presented retrospective analysis of claims data showed.
Researchers found the rate of use of the diagnostic tool in peripheral vascular interventions went from 15.5% in 2018 to 29.2% in 2022 among Medicare beneficiaries undergoing index femoropopliteal interventions for claudication.
Use across all procedure types also increased over the time period, with the steepest rate of increase in cases treated using atherectomy.
Looking at site of service, the study showed that IVUS use in hospital settings nearly doubled (4.8% to 8.8%), while in ambulatory surgery centers (ASCs) and office-based labs (OBLs) IVUS was being used in 48.5% of all femoropopliteal interventions performed for claudication by 2022—up from 30.6% in 2018.
The data were delivered during the 2024 Vascular and Endovascular Surgery Society (VESS) winter annual meeting in Sun Valley, Idaho (Jan. 18–21).
Statistical analysis showed that the cumulative incidence of repeat interventions was “significantly greater when IVUS was used during the index femoropopliteal [procedure] than when it was not,” Sanuja Bose, MD, a postdoctoral research fellow in the Division of Vascular Surgery and Endovascular Therapy at Johns Hopkins University in Baltimore, Maryland, told VESS 2024.
“Overall, IVUS was associated with greater conversion to chronic limb-threatening ischemia after adjusting for the baseline patient characteristics and clustering by physician.”
Senior author Caitlin Hicks, MD, Johns Hopkins’ associate vascular fellowship program director, later told Vascular Specialist IVUS has a “definite role” to play in settings such as the recanalization of chronic total occlusions “but I think that it’s frequently used more than that, and I don’t think it necessarily contributes any meaningful improvement to patient outcomes in all settings.”
