Trends in Percutaneous Device Use for the Treatment of Venous Thromboembolism Over Time in the PINC AI Healthcare Database and the National Inpatient Sample.

The number of different methods of reperfusion therapy to treat venous thromboembolism (VTE) has increased substantially. Nevertheless, investigation of data representativeness and device-level use in administrative databases has been limited. Using the National Inpatient Sample (NIS) and the PINC AI Healthcare Database (PHD), all hospital encounters with a diagnosis code of VTE were identified between January 1, 2016 and December 31, 2020. Patient demographics and trends in treatment modalities were evaluated over time. An algorithm was developed to identify specific devices used for VTE treatment in the PHD cohort. A total of 145,870 patients with VTE treated with reperfusion therapy were identified in the NIS (pulmonary embolism [PE] 88,725, isolated deep vein thrombosis [iDVT] 57,145) and 39,311 in the PHD (PE 25,383, iDVT 13,928). Patient demographics were qualitatively similar in the NIS and PHD. Over time, there was a significant increase in the use of mechanical thrombectomy in the PE and iDVT populations (p <0.05 in both databases), with catheter-directed thrombolysis use plateauing in PE (p = 0.83 and p = 0.14 in NIS and PHD, respectively) and significantly decreasing for the iDVT population (p <0.05 in both databases). In the PHD cohort, specific reperfusion devices were identified in 14,105 patients (PE 9,098, iDVT 5,007). In conclusion, the use of mechanical thrombectomy for the treatment of VTE has increased over time, whereas the rates of catheter-directed thrombolysis therapy have remained stagnant or decreased. Further research is needed to understand the uptake of these treatment modalities and the unique abilities of the PHD to study specific device therapy in the VTE population.
Competing Interests: Declaration of competing interest Suzanne J Baron reports a relationship with AbioMed that includes: consulting or advisory and funding grants. Suzanne J Baron reports a relationship with Boston Scientific that includes: board membership and funding grants. Suzanne J Baron reports a relationship with Edwards LifeSciences that includes speaking and lecture fees. Suzanne J Baron reports a relationship with Medtronic that includes: board membership and speaking and lecture fees. Suzanne J Baron reports a relationship with Shockwave that includes board membership and consulting or advisory. Suzanne J Baron reports a relationship with Zoll Medical that includes: board membership and speaking and lecture fees. Suzanne J Baron reports a relationship with Acarix that includes: funding grants. C Michael Gibson reports a relationship with Boston Scientific that includes: funding grants. C Michael Gibson reports a relationship with Inari Medical that includes: consulting or advisory and funding grants. C Michael Gibson reports a relationship with Penumbra Inc that includes: funding grants. Ripal T Gandhi reports a relationship with Argon Medical Devices that includes: consulting or advisory. Ripal T Gandhi reports a relationship with Becton Dickinson that includes: consulting or advisory. Ripal T Gandhi reports a relationship with Boston Scientific that includes: consulting or advisory. Ripal T Gandhi reports a relationship with Cordis that includes: consulting or advisory. Ripal T Gandhi reports a relationship with Inari Medical that includes: consulting or advisory and speaking and lecture fees. Ripal T Gandhi reports a relationship with Medtronic that includes: consulting or advisory. Ripal T Gandhi reports a relationship with Penumbra Inc that includes: speaking and lecture fees. Derek Mittleider reports a relationship with Boston Scientific that includes: consulting or advisory. Derek Mittleider reports a relationship with Inari Medical that includes: consulting or advisory. David Dexter reports a relationship with AngioDynamics that includes: consulting or advisory. David Dexter reports a relationship with Boston Scientific that includes: consulting or advisory. David Dexter reports a relationship with Inari Medical that includes: consulting or advisory. David Dexter reports a relationship with Penumbra Inc that includes: consulting or advisory. Wissam A Jaber reports a relationship with Abbott that includes: funding grants. Wissam A Jaber reports a relationship with Inari Medical that includes: consulting or advisory. Wissam A Jaber reports a relationship with Medtronic that includes: consulting or advisory and funding grants. Wissam A Jaber reports a relationship with RapidAI that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests.
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