Related Experiment Video
Updated: Aug 5, 2026
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Understanding trends in inpatient surgical volume: vascular interventions, 1980-2000
Patrice L Anderson1, Annetine Gelijns, Alan Moskowitz
1International Center for Health Outcomes and Innovation Reseach (InCHOIR), New York Presbyterian Hospital, Department of Surgery, 600 W. 168th Street, New York, NY 10032, USA. patricea@inchoir.org
Insights
Vascular interventions surged over two decades, with a significant rise in endovascular procedures and a shift towards less invasive treatments, especially for renal and lower extremity diseases. Surgeons must adopt catheter-based methods to lead in peripheral vascular disease care.
Area of Science:
- Cardiovascular Medicine
- Surgical Innovation
- Health Services Research
Background:
- Vascular interventions have evolved significantly over the past few decades.
- Understanding trends in utilization, patient demographics, and hospital stays is crucial for future planning.
- The shift towards minimally invasive techniques has impacted surgical practice.
Purpose of the Study:
- To analyze changes in vascular intervention utilization from 1980 to 2000.
- To examine demographic shifts in patients undergoing vascular procedures.
- To assess trends in hospital length of stay for vascular interventions.
Main Methods:
- Utilized the National Hospital Discharge Survey (NHDS) data from 1980-2000.
- Reviewed International Classification of Diseases, Ninth Revision (ICD-9) codes for vascular procedures.
- Analyzed trends in procedure frequency, patient age, and length of stay.
Main Results:
- Total vascular procedures increased by over 50% per capita, with a notable rise in elderly patients.
- Hospital stays for vascular procedures decreased, with a significant increase in short-stay (<24 hours) interventions.
- Percutaneous/endovascular interventions grew by 979%, indicating a major shift towards less invasive treatments.
- While lower extremity revascularizations declined, amputations increased, and renal-mesenteric operations decreased per capita.
Conclusions:
- Vascular disease interventions have dramatically increased, marked by a significant trend toward less invasive approaches.
- The rise in endovascular interventions necessitates that vascular surgeons adapt to catheter-based techniques.
- These evolving trends highlight the need for vascular surgeons to embrace new technologies for peripheral vascular disease management.
Objective:
To help understand past and future trends in vascular intervention, we examined changes in the rate of utilization, patient demographics, and length of stay from 1980 to 2000.
Methods:
We reviewed the ICD-9 codes for all vascular procedures using the National Hospital Discharge Survey of non-federal United States hospitals (1980-2000).
Results:
The number of vascular procedures performed in this country increased from 412,557 in 1980 to 801,537 in 2000 (per capita increase of >50%). This increase was most evident in elderly patients (>75 years, 67% per capita increase in discharges). Long hospital stays (> or =7 days) for vascular procedures fell 41%, and short hospital stays (<24 hours) increased 15% over the period of study. The frequency of abdominal aortic aneurysm repairs remained relatively constant. Except for an interval in the late 1980s, and a minor decrease from 1997 to 2000, the frequency of carotid endartarectomy rose dramatically (69%). Lower extremity revascularizations increased steadily until 1990 but then declined 12%. From 1995 to 2000, there was a 27% per capita decrease in the number of renal-mesenteric operations. Correspondingly, over the past 5 years there has been a 979% growth in the number of percutaneous/endovascular interventions. Despite a substantial number of interventions for lower extremity vascular disease, there was a concomitant increase in the number of major and minor amputations.
Conclusion:
Interventions for vascular disease have increased dramatically, with a major shift toward less invasive treatments, particularly for the renal and mesenteric vessels and the lower extremities. These trends in procedural use suggest that vascular surgeons need to embrace catheter-based approaches if they want to remain leaders in the treatment of peripheral vascular diseases.
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:22Aneurysm IV: Nursing Management