Use of preprocedural tests by interventional radiologists

A direct survey was taken of 1,238 members of the Society of Cardiovascular and Interventional Radiology (SCVIR) concerning the routine use of 14 tests (most frequently, prothrombin and partial thromboplastin times, complete blood cell counts, and blood urea nitrogen and serum creatinine levels) performed before 10 invasive percutaneous procedures (peripheral angiography, neuroangiography, transluminal angioplasty, thrombolysis, percutaneous needle biopsy, abscess drainage, percutaneous nephrostomy, biliary drainage, myelography, and venography). The survey was undertaken to determine the current practices and appropriateness of current routine use of preprocedural tests. The response rate was 34%, representing a cumulative annual volume of 322,208 cases. The practice of performing routine preprocedural tests is common among interventional radiologists. Data provided by this survey suggest that use of these tests is excessive. Adherence to suggested proposals derived from previously reported experience would result in an annual estimated savings of $20.0-$34.9 million (extrapolated for all procedures performed by SCVIR members in 1989).