To evaluate overall and provider specialty trends in the use of catheter-directed therapy (CDT) for lower extremity deep venous thrombosis (DVT) treatment in the Medicare population.
Using data from the 2007-2017 Centers for Medicare and Medicaid Services 5% Research Identifiable Files, all claims associated with acute and chronic lower extremity DVT were identified. The annual volume of two services – venous percutaneous transluminal thrombectomy (CPT code 37187) and venous infusion for thrombolysis (CPT code 37201 from 2007-2012 and CPT code 37212 from 2013-2017) – were examined for trends in DVT intervention. Utilization rates as well as region and place of service were calculated. Results were further categorized by primary operator type (radiology, cardiology, surgery, and other).
The total number of DVT interventions increased over time with 4.27 service counts per 100,000 beneficiaries in 2007 and increasing to 13.4 by 2017, a growth rate of 12.09%. Radiologists performed the majority of interventions each year except 2013, in which they performed 46.6% of interventions while surgery and cardiology combined performed the other 53.4%. In 2017, radiologists performed 7.56 services per 100,000, which was 56.8% of total counts, more than surgeons, cardiologists, and unspecified providers combined.
CDT is increasingly utilized for the treatment of DVT, undergoing a nearly twelve-fold increase from 2007 to 2017 in the Medicare population. Radiologists remained the dominant provider of these services throughout the majority of study years, with a relative reduction in marketshare from 72% to 57% in 2007 and 2017, respectively.

Copyright © 2021. Published by Elsevier Inc.