Outcomes of Peripheral Endovascular Interventions Based on Hospital Volume: a Mini Review of Published Literature

Introduction The incidence and prevalence of peripheral arterial disease (PAD) has been increasing and it accounts for major morbidity and mortality. Although surgical endarterectomy of arterial occlusive disease remains the gold standard for plaque removal, recent advances in percutaneous endovascular interventions have made this option more viable. Recently there has been advancements in the techniques which claim to provide superior results. Ever since the invention of coronary atherectomy device by John Simpson in 1984 [1], there has been innovations in the endovascular intervention at a tremendous pace. Soon, the technology was used in peripheral arteries for revascularization but the results were not satisfactory in the peripheral arterial circulation [2,3]. Numerous studies have been published citing the influence of hospital volume on the outcomes in the various structural heart diseases but not many studies have been out comparing that with PAD [4]. Methods Hospital procedural volume is an important quality metric in regards to outcomes of procedure [4]. This is especially true in non-emergent, more complicated and less commonly performed procedures such as peripheral endovascular interventions [4,5]. The basis hypothesis that higher procedure volume is associated with better experience has formed the crux of the volume outcome relationships for about four decades now. We present an overview of the available literatures that underscores the importance of hospital volume in peripheral angioplasty, atherectomy and endovascular stenting.