PVI Registry: Driving Understanding, Science, Best Practices

The treatment of lower extremity peripheral artery disease and cerebrovascular disease has evolved in recent years to include more invasive procedures. ACC's PVI Registry is key to understanding patient and procedural characteristics and outcomes, and can play a pivotal role in scientific evidence generation, medical device surveillance and creation of best practices for peripheral vascular intervention (PVI) and carotid artery revascularization, according to authors of a study published in the American Heart Journal.

W. Schuyler Jones, MD, FACC, et al., used data from ACC's PVI Registry to examine patient and procedural characteristics, and examined the design and implementation of the registry. As of Jan. 1, 2019, the registry, launched in 2014, contained data from 208 centers in the U.S. for 45,316 lower extremity PVIs, 12,417 carotid artery stenting (CAS) procedures and 11,027 carotid endarterectomy (CEA) procedures.

PVI now is used more than surgical revascularization as the most common treatment for patients with claudication refractory to medical therapy or exercise training and critical limb ischemia, according to the researchers. The registry tracks this transition of treatment using three modules: lower extremity PVIs, CAS and CEA. Over the next year, more modules are expected to be added to allow for evaluation of patients treated in cath labs, angiography suites and operating rooms. In addition, it is planned that PVI Registry data will be linked with longitudinal data from other sources, such as the Centers for Medicare and Medicaid Services, which will significantly improve the utility of the registry, according to researchers.

The study found most of patients were white (81-93 percent), male (58-62 percent) and were 68-70 years old. The proportion of patients who were asymptomatic was about 44 percent for those who had CAS and 60 percent who underwent CEA. Nearly the same proportion of patients with critical limb ischemia and claudication/atypical limb symptoms had lower extremity PVI.

"The registry has comprehensive data elements, consistent data collection practices and broad coverage across more than 200 centers," researchers conclude. "With expanding capacity of modules, broad partnership with vascular specialists and dedication to perform quality improvement, device surveillance and clinical research, the ACC PVI Registry has successfully launched and is uniquely positioned to play a pivotal role in scientific evidence generation, medical device surveillance and creation of best practices for PVI and carotid artery revascularization."

Keywords: Endarterectomy, Carotid, Peripheral Arterial Disease, Carcinoembryonic Antigen, Quality Improvement, Lower Extremity, Registries, National Cardiovascular Data Registries, PVI Registry, Carotid Arteries, Cerebrovascular Disorders, Angiography

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