Section snippets

Data sources

The study included all Medicare fee-for-service beneficiaries aged ≥66 years who underwent femoropopliteal revascularization by International Classification of Diseases–10th Revision codes between January 1, 2016, and December 31, 2023. Patient comorbidities were identified using the Chronic Conditions Warehouse data, and procedural data were identified using claims codes.

Statistical analyses

Trends of femoropopliteal artery revascularization procedures were examined by quarter year from January 1. 2016, to

Results

During the study period, the number of endovascular revascularization procedures declined 38.2%; the number of surgical revascularization procedures declined 59.7%. PTA was the primary device (27.72%) used for endovascular revascularization before the onset of the paclitaxel-coated device safety concern (years 2016-2018), followed closely by DCB (24.91%). After the paclitaxel safety concern, the use of DCBs declined to a nadir of 17.89% by 2019, with a proportional increase in the use of

Discussion

In this analysis of >275,000 Medicare fee-for-service beneficiaries, we found a substantial decline in endovascular and surgical revascularizations. The paclitaxel safety concern sparked a rapid shift away from the use of paclitaxel-coated devices and toward the use of uncoated devices, particularly PTA. The use of DCBs has only recently regained some ground since its nadir in 2019, but their use remains remarkably low relative to PTA despite evidence supporting their superior efficacy and the

Conclusions

The onset of the paclitaxel safety concern is associated with a decrease in the use of drug-coated device use in femoropopliteal revascularization and is associated with increased mortality, exacerbated further after the onset of the COVID pandemic.

Funding Support and Author Disclosures

This research was sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) and supported by an educational grant from Abbott Vascular. The views presented here represent those of the authors and do not necessarily reflect the official views of SCAI or Abott Vascular. Dr Yeh has received research funding from Boston Scientific, Abbott, and Medtronic; and has been a consultant for Boston Scientific, Abbott, Medtronic, Edwards, CathWorks, and Shockwave. Dr Secemsky has

中文翻译：

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2016 年至 2023 年股腘血运重建的动态趋势和实践模式

 部分片段

 数据源

该研究包括所有年龄在 66 ≥的 Medicare 按服务收费受益人，他们在 2016 年 1 月 1 日至 2023 年 12 月 31 日期间根据国际疾病分类 - 第 10 次修订代码接受了股腘动脉血运重建术。使用 Chronic Conditions Warehouse 数据确定患者合并症，使用索赔代码确定程序数据。

 统计分析

从 1 月 1 日起，按季度检查股腘动脉血运重建手术的趋势。2016 年，至

 结果

在研究期间，血管内血运重建手术的数量下降了 38.2%;外科血运重建手术的数量下降了 59.7%。在紫杉醇涂层装置安全问题出现之前 （27.72-2016%） PTA 是用于血管内血运重建的主要装置 （2016%），紧随其后的是 DCB （24.91%）。在紫杉醇安全性问题之后，到 2019 年，DCB 的使用下降到 17.89% 的最低点，其中

 讨论

在对 >275,000 名 Medicare 按服务收费受益人的分析中，我们发现血管内和手术血运重建大幅下降。对紫杉醇安全性的担忧引发了从使用紫杉醇涂层装置转向使用无涂层装置（尤其是 PTA）的迅速转变。自 2019 年的最低点以来，DCB 的使用最近才恢复了一些进展，但相对于 PTA，它们的使用仍然非常低，尽管有证据支持其卓越的疗效和

 结论

紫杉醇安全问题的发生与股腘动脉血运重建中药物涂层装置使用的减少有关，并且与死亡率增加有关，在 COVID 大流行开始后进一步加剧。

资金支持和作者披露

这项研究由心血管血管造影和介入学会 （SCAI） 赞助，并得到了 Abbott Vascular 的教育资助。此处提供的观点代表作者的观点，并不一定反映 SCAI 或 Abott Vascular 的官方观点。Yeh 博士获得了 Boston Scientific、Abbott 和 Medtronic 的研究资助;并曾担任 Boston Scientific、Abbott、Medtronic、Edwards、CathWorks 和 Shockwave 的顾问。Secemsky 博士