This study investigated changes in utilization of diagnostic imaging-CT angiography (CTA) and MR angiography (MRA)-and treatments-stent placement, angioplasty, atherectomy, and bypass-in PAD across different physician specialties and healthcare facilities from 2011-2021. Data were gathered from the 2011-2021 Physician/Supplier Procedure Summary files and tallied per 100,000 Medicare beneficiaries. Sites of service included inpatients, physician offices, and hospital outpatient departments. Physician specialties included interventional radiologists, interventional cardiologists, and vascular surgeons. From 2011-2021 and per 100,000 Medicare beneficiaries, CTA utilization rates grew (+14%), vascular ultrasound utilization rates decreased (-17%), and MRA utilization rates decreased (-86%). Per 100,000, atherectomy utilization rates increased 159% (37.7 to 55.1), and bypass grafting utilization rates decreased 74% (40.7 to 10.5). Combined, angioplasty, stent placement, stent placement with atherectomy, and atherectomy utilization rates increased (+16%), particularly in the office (angioplasty +277%, atherectomy +1036%). These data support that PAD management shifted toward endovascular procedures in OBLs.
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