Deep venous thrombosis interventions: Change over time and relative percentage performed by Interventional Radiologists.

Monday, March 6, 2023

12:00 PM – 1:00 PM

Location: Phoenix Convention Center, North Ballroom 120 D

Poster Presenter(s)

Navjit Dullet, DO

Resident Physician
University of Arizona - Tucson

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Shamar Young, MD

Professor
University of Arizona
GW

Gregory J. Woodhead, MD, PhD

Assistant Professor
University of Arizona, College of Medicine
DG

Daniel Goldberg, MD

Assistant Professor
University of Arizona
JH

Jack Hannallah, MD, MBA, MPH

Assistant Professor
University of Arizona - Banner University Medical

Disclosure(s):

Navjit Dullet, DO: No financial relationships to disclose

Shamar Young, MD: Boston Scientific: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing), Speaking and Teaching (Ongoing); Galvanize Therapeutics: Consultant (Ongoing); Histosonics Inc: Consultant (Terminated); Mirada: Consultant (Ongoing); Varian: Consultant (Ongoing)

Gregory J. Woodhead, MD, PhD: No relevant disclosure to display

Purpose: To determine the affect that the ATTRACT trial had on total number of patients with deep venous thrombosis (DVT) who were treated with mechanical thrombectomy or lysis. Furthermore, given the emergence of several new mechanical thrombectomy devices the change in relative percentage of lysis and mechanical thrombectomy was also evaluated.

Materials and Methods: The "Medicare Provider Utilization and Payment Data" database was utilized to find all patients who underwent mechanical thrombectomy or lysis for deep vein thrombosis (DVT). The ATTRACT trial was released in 2017 and for this reason 2016 was utilized as the reference year for changes. As there are three subspecialties of medicine which commonly perform this procedure (Interventional Radiology (IR), Interventional Cardiology (IC), and Vascular Surgery (VS)) the relative number each sub-specialty did was also recorded. As IRs are often misregistered as diagnostic radiologist, this group was included in the IR numbers.

Results: Table 1 demonstrates the total number of cases performed by year starting in 2016. If we use 2016 as our index year there was a -32.4%, -25.7%, -40.1%, and -60.7% reduction in 2017, 2018, 2019, and 2020 respectively. If we evaluate year over year (YOY) percentage change then there was a -32.4%, 9.8%, -19.4%, and -34.4% change from 2016-2017, 2017-2018, 2018-2019, and 2019-2020 respectively. Lysis represented 21.1%, 31.3%, 51.9%, 41.1%, and 31.5% of the total number of DVT interventions performed in 2016, 2017, 2018, 2019, and 2020 respectively. When looking at procedures done by sub-specialty, the ICs did very few and so were not included in the analysis. When looking at the percentage of total DVT procedures performed by IRs per year it was 10.3%, 13.9%, 39.1%, 64.2%, 73.9%, 80.8%, 67.9%, and 72.3% respectively from 2013-2020.

Conclusion: While the total number of DVT interventions appear to have decreased following the release of the ATTRACT trial, the relative percentage performed by IRs has increased over an 8-year period.