Welcome to the PVI Registry's Educational Overview. The content in this presentation was developed by Betsy Weimer and Christina Kutras. I am John Jurout, and I will be narrating this presentation. The objectives of this presentation are to describe the purpose of the PVI Registry, elucidate the significance of peripheral vascular disease, and define inclusion and exclusion criteria. The purpose of the PVI Registry is to assess the prevalence, demographics, management, and outcomes of patients undergoing carotid stenting, carotid endarterectomy, and catheter-based peripheral revascularization. The primary aims of the PVI Registry are to optimize the outcomes and management of patients through the implementation of evidence-based guideline recommendations in clinical practice, to facilitate efforts to improve the quality and safety of carotid and catheter-based peripheral revascularization, investigate novel quality improvement methods, and to provide risk-adjusted assessment of patients for comparison with nationwide NCDR data. The secondary aim of the PVI Registry is to serve as a rich source of data for outcomes and comparative effectiveness research. PVD encompasses a range of non-coronary vascular syndromes that are caused by the altered structure and function of the arteries and veins that supply the brain, visceral organs, and limbs. PVD is often a consequence of systemic disease processes that affect multiple circulations, the most common of which is atherosclerosis. The AHA estimates that over 8 million Americans suffer from PVD. The incidence of atherosclerotic PVD increases with age and is increased in patients with atherosclerotic risk factors, which include smoking, diabetes, hypertension, hypercholesterolemia, hyperhomocystinemia, and elevated C-reactive protein. A risk factor increases your chance of developing a disease. Some risk factors can be changed, others cannot. Risk factors that you can't change include age, especially older than the age of 50, history of heart disease, male gender, postmenopausal women, and family history of high cholesterol, high blood pressure, or peripheral vascular disease. Risk factors that may be changed or treated include coronary artery disease, diabetes, high cholesterol, high blood pressure, overweight, physical inactivity, smoking, or use of tobacco products. Those who smoke or have diabetes have the highest risk of complications from PVD because these risk factors also cause impaired blood flow. Inclusion criteria for the lower extremity patient population includes adult patients who are 18 years of age and older and receive a catheter-based arterial intervention of the lower extremities from the aortoiliac bifurcation to the metatarsal arteries, including bypass grafts to the lower extremities. Treatments include percutaneous transluminal angioplasty, stenting, atherectomy, thrombolysis, and covered stent to treat aneurysmal disease. Procedures that are not currently captured for the lower extremity population include abdominal aortic aneurysm, internal iliac artery embolization, venous or lymphatic procedures, head and neck, upper extremity, aortic, mesenteric, or renal interventions, treatment of dialysis grafts, and diagnostic procedures not associated with arterial interventions and any peripheral intervention for trauma. Inclusion criteria for the carotid patient population, CASCEA, includes adult patients who are 18 years of age and older, patients treated for fibromuscular dysplasia or spontaneous carotid artery dissection, and those patients receiving carotid intervention of atherosclerotic stenosis of the internal, common carotid, and or bifurcation of the common artery. Examples include endovascular therapies, surgical treatment, and treatment of acute stroke in evolution. Exclusion criteria for the carotid population includes procedures being performed due to trauma and erosion. Examples of trauma include motor vehicle accident with carotid involvement, fall with carotid involvement, or gunshot wound to the carotid artery. Examples of erosion include patients with neck cancer that affects the carotid artery. Both trauma and erosion of atherosclerotic plaque is more complicated with higher risks. There is an option to capture follow-up for the PVI registry population. Follow-up is not mandated and is captured at 30 days post-procedure and one year post-procedure. Follow-up is for all PVI procedures, which include carotid artery stenting, carotid and artery erectomy, and catheter-based arterial and lower extremity interventions. As a nationally recognized surveillance tool, the PVI registry is well-positioned within the healthcare industry and provides participants weekly access to their data and metric performance through an interactive dashboard and quarterly benchmark feedback through the published outcomes report. This data supports ongoing quality improvement efforts by hospitals performing this life-saving intervention. The PVI registry has also become a tool for outside stakeholders, healthcare systems, states, and payers who use it to assess the incidents and trends of procedures, and the quality of care provided by providers and the centers engaged in performing these procedures. It supports numerous research initiatives, informs clinical practice, and guideline development. The PVI registry is governed by a 7-10 member steering committee with a chair, a representative from the Society for Cardiovascular Angiography and Interventions, SCAI, member society, and ex-officio members from the PVI registry research and publication subcommittee and NCDR management board. Committee members have expertise in clinical practice, financial management, quality measurement and improvement, and or health system strategy and innovation. The steering committee provides strategic oversight and direction of the registry, guidance for program activities, and helps identify and prioritize research initiatives. Committee recommendations are provided to the NCDR management board, thus helping to inform and influence the direction of the NCDR. This concludes the overview of the PVI registry. Thank you for your participation.

PVI Registry

vascular procedures

Peripheral vascular disease

atherosclerosis

quality improvement