Hi ekw70-ga and thanks for your question.
Regarding the numbers of percutaneous transluminal procedures
performed yearly, an article published in 2003 by Pentecost, et al.,
in the Journal of Vascular and Interventional Radiology addresses this
issue and gives an excellent overview of the indications, outcomes,
complications, etc., involved in this type of treatment. Further, the
article contains 207 references at the end if you should require
further details on any particular area. The free full-text PDF
article can be found here:
http://wwws.acponline.org/journals/ecp/sepoct01/axelrod.pdf
From the above report, we get a sense of the magnitude of how many
people in the US suffer from Peripheral Vascular Disease:
"Every year 55,000 men and 44,000 women had a first listed diagnosis
of chronic PAD, and 229,000 men and 184,000 women had chronic PAD
noted at discharge. In the latter group 66.3% of the men and 74.1% of
the women were 65 years old or older." [see Ref. 20]
The age-specific incidence of PAD is broken down in Table 1 (page 2).
Directly addressing your question, [Ref 20], cited by the above
article, gives these statistics:
"Interventional techniques were the most common procedure used to
treat chronic PAD, with 88,000 hospital discharges, a sharp increase
from 37,000 in 1979."
These numbers are corroborated in a second article by Levin, et al.,
also in the Journal of Vascular and Interventional Radiology:
"PERCUTANEOUS transluminal angioplasty of peripheral, renal, and
visceral arteries has been in widespread clinical use for more than a
decade, and it is estimated that approximately 100,000 of these
procedures are performed annually in the United States."
Full article is here:
http://www.jvir.org/cgi/content/full/14/9/S359?ck=nck
In terms of surgical intervention for PVD / PAD, the following numbers are given:
"Aorto-iliac femoral bypass was coded for 31,000 discharges, a sharp
increase from 18,000 in 1979. Other shunt or bypass procedures were
coded for 74,000 discharges, compared with 46,000 in 1979."
Another surgical technique other than bypass that is sometimes used in
treatment of PVD / PAD is endarterectomy. The following statistics
are quoted in the source above:
"Endarterectomy of lower limb arteries was listed for 17,000
discharges, compared with 10,000 in 1979."
The article also discusses trends in treatment of PAD, focusing on a
study that looked at patients in the Maryland area:
"A recently published study conducted in Maryland confirms the sharp
increase in procedures for PAD noted in the NCHS data (21). Between
1979 and 1989 the rate of percutaneous transluminal angioplasty for
PAD rose from 1 to 24 per 100,000 Maryland residents. Despite this
dramatic increase, the annual rate of peripheral bypass surgery also
increased sharply, from 32 to 65 per 100,000. Despite these two
therapeutic interventions, the annual rate of lower extremity
amputation was stable at 30 per 100,000. In constant dollars, total
hospital charges for stays involving a revascularization procedure
increased from $14.7 million in 1979 to $30.5 million in 1989."
If you are interested, the above article goes on to discuss
complications from these procedures, problems with restenosis, the
history of treatment of PAD, etc. Early in the article, the authors
discuss amputations and deaths attributed to PAD, as well as
connections to coronary artery disease.
_____________________________________
Also of potential interest is the following article from the American
College of Physicians, which looked at Medicare patients receiving
peripheral angioplasty. Although the focus of the article is on
cardiologists performing these procedures (as opposed to
interventional radiologists), the authors include a particularly
interesting figure showing the frequency of use of percutaneous
angioplasty as compared to the national average (Figure 1, page 4).
Also of potential interest, the article contains a second figure
showing the percentage of these procedures performed by cardiologists
(Figure 2, page 5).
The free full-text PDF of the article can be found here:
http://wwws.acponline.org/journals/ecp/sepoct01/axelrod.pdf
_____________________________________
Useful searches:
On scholar.google.com:
review "per year" surgery percutaneous "peripheral vascular disease"
(dates 1999-2005)
surgery percutaneous "peripheral vascular disease" (dates 1999-2005)
"per year" surgery percutaneous "peripheral vascular disease"(dates 1999-2005)
I hope this information was useful. Feel free to request any clarification.
-welte-ga |
