Lower Limb Angioplasty/Stent

What is lower limb angioplasty/stenting?

Peripheral arterial disease (PAD) is a restriction of the blood flow in the lower-limb arteries. It can severely affect a patient’s quality of life. The disease can affect various sites in the legs, and produces symptoms that vary in their severity from pain in the legs during exercise to persistent ulcers, or gangrene.

One of the treatments available for PAD involves a medical procedure whereby a small balloon is passed into a narrow section of an artery, via a catheter. The balloon is inflated to open up the artery in order to improve blood flow. This is known as an angioplasty. A metal scaffold (called a stent) may also be inserted into the artery to hold it open.

What information is being published on lower limb angioplasty/stenting?

For each NHS trust/Welsh Health Board, we present the number of procedures they submitted to the NVR in the reporting period. The colour and symbol next to this number indicate the case ascertainment, which is the number of procedures the trust submitted compared to the total they carried out according to national data sources.

We also publish the average length of stay for patients undergoing a lower limb angioplasty/stent procedure. The numbers in brackets are the typical range that patients will stay in hospital. The results for a particular organisation can be seen in relation to the overall national length of stay.

The final row is the risk adjusted in-hospital survival rate for lower limb angioplasty/stenting for the trust. Again, this can be seen in comparison to the overall national survival rate.

The information on this website was published in November 2021.

What data is being used to produce the outcome information?

The results for lower limb angioplasty/stenting are based on procedures carried out between 1st January 2018 and 31st December 2020.

How are the data analysed?

The results have been risk adjusted for patient case-mix to ensure that NHS trusts that take on more difficult cases are not unfairly penalised. The reason for producing risk-adjusted outcomes is because the characteristics of patients treated by an NHS trust will vary, and the outcome of care will be influenced by these characteristics – on average, outcomes are often worse for sicker patients. Risk adjustment allows us to take account of these factors.

For outcomes after lower limb angioplasty/stenting, we used a risk model that took account of the differences in patient populations within each organisation.
The risk adjustment model included admission mode, presenting problem, Fontaine score, patient age, chronic lung disease, chronic renal disease, chronic heart failure, smoking status and national COVID-19 admission rates.