Update on CLI Patients and Complications From the OEIS National Registry

An Interview With Bret Wiechmann, MD

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VASCULAR DISEASE MANAGEMENT. 2024;21(12):E123 

At the 2024 Amputation Prevention Symposium (AMP), interventional radiologist Bret Wiechmann, MD, medical director at Vascular & Interventional Physicians in Gainesville, Florida, discussed his presentation on the Outpatient Endovascular and Interventional Society (OEIS) Registry, which details outcomes within outpatient interventional suites to promote quality and identify benchmarks for best practices. Below is an edited transcription of the video Dr. Wiechmann recorded for us at AMP, which you can watch here. 

The OEIS National Registry was developed as part of the educational and quality aspects of OEIS, and the peripheral module began in 2017, which was only 4 years after we started the society, so a pretty heavy lift that was important from our standpoint as it represented one of the pillars of why we formed the Society. The peripheral arterial module now has over 45,000 procedures in it, which is a pretty robust data set. And within that data set, we look at outcomes for patients with peripheral arterial disease (PAD) and critical limb ischemia (CLI). Of those 45,000 procedures, a little bit over 15,000 of those patients, or 30-plus percent, are patients with CLI. The data that are out there right now for complication rates is what I presented today at the AMP meeting. And what that looks like, basically, is about 15,500 CLI procedures, which represents roughly between 36% and 45% of all the entrants into the registry. What we have shown through that is very competitive data as they pertain to complication rates to other databases that may be out there, whether that's the Vascular Quality Initiative (VQI) or the Excellence in Peripheral Artery Disease (XLPAD) Registry. What those outcomes have shown is pretty impressive. 

The snapshot that you get as part of being a member of the OEIS Registry is a comparative way of judging your outcomes based on others within the Registry. It is informative on an individual basis, but it is also a good measure of your own outcomes and it provides OEIS and other interested industry partners with some outcomes data for a particular device or a particular subset of patients, whether it might be the superficial femoral artery or below the knee.

What we have shown is a roughly 2.8% complication rate in patients with CLI. That is across the board in the entire Registry, which is, again, very competitive with the numbers that are produced by other registries. 

What I think it shows is a couple things. Number one, the OEIS Registry is open to anybody who does peripheral vascular intervention. Ideally you are an OEIS member, and there is an opportunity to get some cost reduction for being a part of the Registry if you're an OEIS member. But there is a lot of attention on what we do in the outpatient, or the non-hospital, side of service these days. One of the reasons why we formed the Registry is to show people that the non-hospital side of service is a safe place to do these procedures and provide just as good clinical outcomes, if not better. And again, if you look at that overall data set, I think it proves to the general public, and to the vascular community as a whole, that we are putting our best foot forward and trying to prove this through objective data: very low transfer rates to the hospital, low complication rates for individual patients, and low mortality rates in a very complicated patient population. Again, in all-comers across the board of 45,000 procedures, roughly 36% to 45% of those patients have CLI, so it is a very difficult patient population, yet they have very few complication rates. n