• Sidakpal S Panaich, Shilpkumar Arora, Nilay Patel, Nileshkumar J Patel, Chirag Savani, Achint Patel, Badal Thakkar, Vikas Singh, Samir Patel, Nish Patel, Kanishk Agnihotri, Parth Bhatt, Abhishek Deshmukh, Vishal Gupta, Ramak R Attaran, Carlos I Mena, Cindy L Grines, Michael Cleman, John K Forrest, and Apurva O Badheka.
• Borgess Medical Centre, Kalamazoo, MI, USA.
• J. Endovasc. Ther. 2016 Feb 1; 23 (1): 65-75.

PurposeTo examine the impact of intravascular ultrasound (IVUS) utilization during lower limb endovascular interventions as regards postprocedural complications and amputation.MethodsThe study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database between the years 2006 and 2011. Peripheral endovascular interventions were identified using appropriate ICD-9 procedure codes. Two-level hierarchical multivariate mixed models were created. The co-primary outcomes were in-hospital mortality and amputation; the secondary outcome was postprocedural complications. Model results are given as the odds ratio (OR) and 95% confidence interval (CI). Hospitalization costs were also assessed.ResultsOverall, among the 92,714 patients extracted from the database during the observation period, IVUS was used in 1299 (1.4%) patients. IVUS utilization during lower extremity peripheral vascular procedures was independently predictive of a lower rate of postprocedural complications (OR 0.80, 95% CI 0.66 to 0.99, p=0.037) as well as lower amputation rates (OR 0.59, 95% CI 0.45 to 0.77, p<0.001) without any significant impact on in-hospital mortality. Multivariate analysis also revealed IVUS utilization to be predictive of a nonsignificant increase in hospitalization costs ($1333, 95% CI -$167 to +$2833, p=0.082).ConclusionIVUS use during lower limb endovascular interventions is predictive of lower postprocedural complication and amputation rates with a nonsignificant increase in hospitalization costs.© The Author(s) 2015.

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