Importance of access to fixed-imaging fluoroscopy: Practice implications for the vascular surgeon

Sternbergh, W. Charles, Tierney, W. Andrew and Money, Samuel R. (2004). Importance of access to fixed-imaging fluoroscopy: Practice implications for the vascular surgeon. In: 28th Annual Meeting of the Southern-Association-for-Vascular-Surgery, Rio Grande, Puerto Rico, (404-410). 14-17 January 2004. doi:10.1583/04-1247.1

Author Sternbergh, W. Charles
Tierney, W. Andrew
Money, Samuel R.
Title of paper Importance of access to fixed-imaging fluoroscopy: Practice implications for the vascular surgeon
Conference name 28th Annual Meeting of the Southern-Association-for-Vascular-Surgery
Conference location Rio Grande, Puerto Rico
Conference dates 14-17 January 2004
Journal name Journal of Endovascular Therapy   Check publisher's open access policy
Place of Publication Lawrence, KS, United States
Publisher Allen Press
Publication Year 2004
Sub-type Fully published paper
DOI 10.1583/04-1247.1
ISSN 1526-6028
Volume 11
Issue 4
Start page 404
End page 410
Total pages 6
Language eng
Formatted Abstract/Summary
Purpose: To examine the impact of unfettered access to high quality fixed-imaging fluoroscopy in a vascular surgery practice.

Methods: The case mix of 2 vascular surgeons was retrospectively examined for a 12-month period before (period A) and after (period B) routine access to fixed-imaging equipment was established. Operative and endovascular cases were identified by their CPT codes. Trends in procedure frequency and gross charges were assessed.

Results: Endovascular code usage increased 174% (p<0.001) following routine access to fixed imaging equipment. There was an overall 2.3-fold increase in angioplasty across all vascular beds (p<0.001), as well as a 2.1-fold increase in stent utilization (p<0.001). More complex diagnostic and interventional procedures were performed, as evidenced by a large increase in third-order catheterizations (p<0.001). Open surgical therapy decreased overall by 11.4% (p=0.051) in period B. Reductions in open surgery for peripheral arterial occlusive disease were most pronounced, decreasing 35.6% (p<0.001). Overall gross charges increased 6% in group B. Endovascular procedures accounted for 36.6% of gross charges in period B, doubling its contributions from period A (17.1%, p=0.01). Open major vascular case contributions to gross charges fell from 54.4% to 36.2%.

Conclusions: A significant shift in case mix was observed after routine access to fixed imaging equipment was established, with a dramatic increase seen in percutaneous endovascular case volume and complexity. Corresponding contributions to gross charges for endovascular procedures became equivalent to that of all open major vascular cases combined. Routine access to fixed imaging fluoroscopy appeared to be the chronological fulcrum on which the balance of endovascular and open vascular cases has shifted, allowing the development of a fully integrated vascular and endovascular practice.
Keyword Peripheral vascular disease
Percutaneous techniques
Endovascular procedures
Intraprocedural imaging
Imaging equipment
Vascular practice
Cost analysis
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:05:45 EST