Aortic & peripheral vascular diseaseCohort study
The Shifting Landscape of Chronic Limb-Threatening Ischemia Revascularization Toward Ambulatory Surgical Centers and Outpatient-Based Laboratories
- Retrospective cohort study
- Medicare fee-for-service claims
- multivariable Cox regression
Authors' conclusion
By 2023, ASC/OBLs emerged as the dominant setting for CLTI revascularization among Medicare beneficiaries. Although ASC/OBLs were associated with improved outcomes, the observational nature of this analysis and residual confounding limit causal conclusions.
Study context
- Population
- Medicare beneficiaries aged ≥66 years undergoing lower extremity peripheral vascular intervention (PVI) for chronic limb-threatening ischemia (CLTI), 2016–2023820,381 revascularizations
- Participants
- 925,905 beneficiaries
- Exposure
- ASC/OBL vs hospital-based outpatient vs hospital-based inpatient PVI
- Outcome
- Composite of:
- All-cause mortality
- Major amputation
Main finding
As reported in the abstract
Hazard ratio (95% CI)
ASC/OBL vs Hospital-based outpatient
0.93(0.92–0.94)
ASC/OBL vs Inpatient
0.47(0.45–0.49)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | ASC/OBL | Hospital-based outpatient | Inpatient |
|---|---|---|---|
| Proportion of revascularizations in ASC/OBLs · 2023 | 46.72% | Not reported in the abstract | Not reported in the abstract |
Composite of death or major amputation, overall · median follow-up 657 days (Q1-Q3: 204-1,378 days)
- Death or major amputation
- 188,033 (56.4%)
- Deaths
- 176,140 (52.9%)
- Major amputations
- 36,743 (11.0%)
Repeat revascularization and ambulatory status
- Higher rates of repeat revascularization with ASC/outpatient-based laboratories (OBLs)
- Similar changes in ambulatory status
Original publication
The Shifting Landscape of Chronic Limb-Threatening Ischemia Revascularization Toward Ambulatory Surgical Centers and Outpatient-Based Laboratories. JACC Cardiovasc Interv. Published 10 November 2025. doi:10.1016/j.jcin.2025.09.010
Summarised from the published abstract; every number is checked against it