Evidence mapPaperPMID 40311752Full record

ArticleAnnals of vascular surgery2025

Use of Intravascular Ultrasound during Peripheral Vascular Interventions for Claudication Is Not Associated with Improved Outcomes.

Chen Dun, M Libby Weaver, Sanuja Bose, Katherine M McDermott, Sarah E Deery, James H Black, Jeffrey J Siracuse, Jesse Columbo, Caitlin W Hicks

Abstract readComparative Study
In one paragraph

Article in Annals of vascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Chen DunDepartment of Biomedical Informatics and Data Science, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: cdun1@jhmi.edu.
M Libby WeaverDivision of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, VA.
Sanuja BoseDivision of Vascular Surgery and Endovascular Therapy, The Johns Hopkins University School of Medicine, Baltimore, MD.
Katherine M McDermottDivision of Vascular Surgery and Endovascular Therapy, The Johns Hopkins University School of Medicine, Baltimore, MD.
Sarah E DeeryDivision of Vascular Surgery, Maine Medical Center, Portland, ME.
James H BlackDivision of Vascular Surgery and Endovascular Therapy, The Johns Hopkins University School of Medicine, Baltimore, MD.
Jeffrey J SiracuseDivision of Acute Care Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Jesse ColumboSection of Vascular Surgery, Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Lebanon, NH.
Caitlin W HicksDivision of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, VA. Electronic address: chicks11@jhmi.edu.

Funding

Risk Factors and Outcomes Associated with Late-Life Diabetic Peripheral NeuropathyK23DK124515 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI Caitlin Whitney Hicks · 2022 to 2023
$354k
Comparative-Effectiveness of Procedures for Carotid RevascularizationK08HL165087 · DARTMOUTH-HITCHCOCK CLINIC · 2025 to 2025
$147k
NHLBI NIH HHS K08 HL165087NIDDK NIH HHS K23 DK124515
6 · The paper itself

Abstract

backgroundThe efficacy of intravascular ultrasound (IVUS) for improving outcomes of peripheral vascular interventions (PVIs) has not been well studied. We aimed to evaluate the association of IVUS with long-term outcomes in patients undergoing PVI for claudication.

methodsWe conducted a two-cohort study using data from 100% of Medicare fee-for-service claims (2018-2022) and the Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network (VISION; 2016-2019). For both cohorts, we identified all patients who underwent an index (first-time) femoropopliteal PVI for claudication, excluding patients with chronic limb-threatening ischemia (CLTI) and acute limb ischemia. We compared IVUS use over time and by procedure type and setting. We used multivariable Cox proportional hazards models to assess the associations of IVUS with repeat PVI, conversion to CLTI, and amputation. For the Medicare cohort, adjustments were made for baseline patient characteristics, while for the VISION cohort, additional adjustments were made for detailed anatomic factors. All models were clustered by physician.

resultsIn the Medicare dataset, 69,092 patients (median age 74 years; 40.5% female; 12.1% non-Hispanic Black) underwent an index femoropopliteal PVI for claudication, of whom 22.1% (N = 15,253) received IVUS. In the VISION dataset, 6,722 patients (median age 72 years; 38.7% female; 11.6% non-Hispanic Black) underwent an index femoropopliteal PVI for claudication, of whom 3.8% (N = 254) received IVUS. The mean follow-up time for both cohorts was 2.7 years. For both the Medicare and VISION cohorts, IVUS use significantly increased over time, particularly in ambulatory surgery center/office-based laboratory settings and in conjunction with atherectomy procedures (P < 0.001). In the Medicare cohort, IVUS use was associated with a higher hazard of repeat PVI (adjusted hazard ratio [aHR] 1.07, 95% CI 1.02-1.12) and progression to CLTI (aHR 1.11, 95% CI 1.03-1.20) after adjustment compared to PVI without IVUS. In the VISION cohort, there were no significant differences in outcomes between IVUS and non-IVUS cases (all, P > 0.05).

conclusionThe use of IVUS for the treatment of claudication is rapidly increasing, without clear benefits in outcomes. The role of IVUS in treating claudication deserves further investigation.

Indexed as

Endovascular ProceduresFemoral ArteryIntermittent ClaudicationPeripheral Arterial DiseasePopliteal ArteryUltrasonography, InterventionalAgedAged, 80 and overAmputation, SurgicalDatabases, FactualFemaleHumansLimb SalvageMaleMedicareMiddle Aged

Identifiers

PMID40311752
PMCPMC12335370

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.