Effect of Diabetes on Clinical Outcomes in Patients with Peripheral Arterial Disease undergoing Lower Extremity Revascularization: A Systematic Review and Meta-Analysis.

Introduction: Peripheral arterial disease (PAD) is highly prevalent and has a well-established association with diabetes mellitus (DM). However, it remains unclear whether DM worsens clinical outcomes after lower extremity revascularization (LER).

Methods: We performed a systematic search of six databases (Cochrane Library, Embase, Google Scholar, Medline, Scopus, and Web of Science) until February 2024, including studies that reported a risk estimate for the association of diabetes mellitus with 30-day all-cause mortality, hospital readmission, major amputation, and wound infection for patients following LER.

Association between guideline-directed medical therapy and reintervention risk following peripheral vascular interventions in patients with peripheral artery disease.

Introduction: Reintervention following peripheral vascular intervention (PVI) for peripheral artery disease (PAD) is common. Guideline-directed medical therapy (GDMT) is recommended post-PVI, yet its association with reintervention outcomes remains unclear.

Methods: We analyzed Vascular Quality Initiative registry data linked with Medicare outcome for patients undergoing PVI for PAD (2017-2018).

Defining Thresholds for Meaningful Health Status Changes Following Transfemoral Carotid Artery Stenting.

Background: Evaluating health status changes following transfemoral carotid artery stenting (TF-CAS) is essential for assessing procedural success, but meaningful clinical changes are unknown. We aimed to determine minimal clinically important differences (MCIDs) and quantify health status improvement or worsening rates after TF-CAS using the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) registry data.

Methods: The SAPPHIRE registry included patients undergoing TF-CAS from 2010 to 2014 for both symptomatic and asymptomatic carotid stenosis.

Lack of diversity in patients undergoing carotid artery stenting: Implications for the Distressed Community Index.

Introduction: As the role of social determinants in carotid artery stenting (CAS) outcomes remains unclear, we investigated the association between the Distressed Community Index (DCI) (zip-code based) and post-CAS mortality/stroke outcomes.

Methods: We analyzed patients undergoing CAS from 2015 to 2019 using the Medicare claims-linked Vascular Quality Initiative database. Patients were grouped based on high (DCI ⩾ 60) and low (DCI < 60) community distress.

Association of health status and hospitalization risk for peripheral artery disease in the PORTRAIT registry.

Background: Healthcare utilization for patients with peripheral artery disease (PAD) is high, but stratifying patients' risk of hospitalization at initial evaluation is challenging. We examined the association between health status at PAD presentation and risk of (1) combined all-cause hospital admissions and emergency department (ED) visits and (2) all-cause hospital admissions.

Methods: Patients with claudication enrolled at US sites in the PORTRAIT registry were included.

Competing risk analysis to estimate amputation incidence and risk in lower-extremity peripheral artery disease.

Patients with peripheral artery disease face high amputation and mortality risk. When assessing vascular outcomes, consideration of mortality as a competing risk is not routine. We hypothesize standard time-to-event methods will overestimate major amputation risk in chronic limb-threatening ischemia (CLTI) and non-CLTI.

Twelve-month health status response after peripheral vascular intervention for femoropopliteal lesions using Zilver PTX databases focusing on the role of preprocedural health status, comorbid risks, and global setting.

Objective: Tailoring resources of peripheral vascular interventions (PVIs) to those who stand to gain the most would allow for more equitable and value-based care. One way of evaluating the benefit of PVIs in patients with symptomatic peripheral artery disease is evaluating their health status and identifying predictors of health status response 12 months after the intervention.

Methods: Patients who underwent femoropopliteal PVI between March 2005 and August 2008 from the Zilver PTX randomized trial and single-arm study were combined into a single cohort for secondary data analysis.

Association of social support and health status outcomes in peripheral artery disease.

Objective: A critical goal in the care of patients with peripheral artery disease (PAD) is to optimize their health status; that is, their symptoms, function, and quality of life. Social support has been proposed to be a predictor of disease-specific health status in patients with PAD. However, the prevalence of low perceived social support, the association with health status outcomes, and the interaction with other biopsychosocial variables, is unknown.

Addressing Psychosocial Care Needs in Women with Peripheral Artery Disease.

Purpose Of Review: Peripheral artery disease (PAD) is a growing global epidemic. Women with PAD are at elevated risk of experiencing psychosocial stressors that influence the diagnosis, management, and course of their illness due to unique sex- and gender-based factors.

Recent Findings: We review existing evidence for increased psychosocial risk in women with PAD with a focus on mood disorders, chronic stress, pain experiences, substance use disorders, health behaviors and illness perceptions, and healthcare access.

Long-Term Mortality Predictors Using a Machine-Learning Approach in Patients With Chronic Limb-Threatening Ischemia After Peripheral Vascular Intervention.

Background: Patients with chronic limb-threatening ischemia (CLTI) face a high long-term mortality risk. Identifying novel mortality predictors and risk profiles would enable individual health care plan design and improved survival. We aimed to leverage a random survival forest machine-learning algorithm to identify long-term all-cause mortality predictors in patients with CLTI undergoing peripheral vascular intervention.

Impact of early intervention on health status outcomes in peripheral artery disease patients with chronic total occlusion lesions using the PORTRAIT registry.

Objective: To analyze the impact of noninvasive and early invasive treatments on health status in patients with lower extremity peripheral arterial disease (PAD) without and with chronic total occlusions (CTOs) after 12 months of follow-up.

Methods: Using the international (the United States, the Netherlands, and Australia) observational longitudinal Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories registry, we included patients with recent PAD symptoms between June 2011 and December 2015. We assessed the PAD-specific health status at initial visit and the 3-, 6-, and 12-month follow-up using the Peripheral Arterial Questionnaire.

Variability in short-term mortality following repair of ruptured abdominal aortic aneurysms across centers and physicians.

Background: Variation in the care management of repairs for ruptured infrarenal abdominal aortic aneurysms between centers and physicians, such as procedural volumes, may explain differences in mortality outcomes. First, we quantified the center and physician variability associated with 30- and 90-day mortality risk after ruptured open surgical repair (rOSR) and ruptured endovascular aneurysm repair (rEVAR). Second, we explored wheter part of this variability was attributable to procedural volume at the center and physician levels.

Inter-Rater Reliability for the Amputation Endpoint in the National Vascular Quality Initiative.

Background: National quality reporting efforts after revascularization for peripheral artery disease (PAD) are ongoing. Validation of endpoints are necessary in national quality registries.

Objectives: This study sought to examine the interrater reliability for the endpoint of major amputation at 1 year in the Vascular Quality Initiative (VQI) registry and the Medicare-linked Vascular Quality Initiative registry (VQI-VISION) against electronic health record (EHR) review.

Impact of comorbid opioid use disorder and major depressive disorder on healthcare utilization outcomes in patients with peripheral artery disease: A National Readmission Database analysis.

Background: Prior research has demonstrated that individuals with peripheral artery disease (PAD) often have comorbid opioid use disorder (OUD) and major depressive disorder (MDD), with limited data regarding their impact on readmission outcomes, length of stay, and cost. This study aimed to investigate these healthcare utilization outcomes in patients with PAD who have comorbid OUD and MDD.

Methods: Data were obtained from the National Readmission Database from 2011 through 2018.

Evaluation of short-term mortality in patients with Medicare undergoing endovascular interventions for chronic limb-threatening ischemia.

Introduction: Patients with chronic limb-threatening ischemia (CLTI) have high mortality rates after revascularization. Risk stratification for short-term outcomes is challenging. We aimed to develop machine-learning models to rank predictive variables for 30-day and 90-day all-cause mortality after peripheral vascular intervention (PVI).

Variability in guideline-directed medical therapy across sites and operators and long-term mortality and amputation outcomes risk in patients undergoing peripheral vascular interventions.

Background: The use of guideline-directed medical therapy (GDMT) in patients undergoing peripheral vascular interventions (PVIs) decreases the risk of death and amputation and may decrease hospital readmissions. The variability of GDMT prescription across sites and operators and the proportionality of risk is not well understood. We aimed to study the association between variability of GDMT prescription at the site and operator level and outcomes (including 90-day readmissions and 24-month all-cause mortality and major amputation).

Psychosocial and socioeconomic factors are most predictive of health status in patients with claudication.

Background: As a key treatment goal for patients with symptomatic peripheral artery disease (PAD), improving health status has also become an important end point for clinical trials and performance-based care. An understanding of patient factors associated with 1-year PAD health status is lacking in patients with PAD.

Methods: The health status of 1073 consecutive patients with symptomatic PAD in the international multicenter PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) registry was measured at baseline and 1 year with the Peripheral Artery Questionnaire (PAQ).