News: Atherectomies performed on 30,000 patients with questionable need for it, analysis finds

Nearly 30,000 patients may have undergone an atherectomy procedure too soon or possibly even unnecessarily, according to a new ProPublica data analysis. Consulted experts said that atherectomies are appropriate for severe vascular disease, but the majority of patients with milder symptoms like claudication—a condition of experiencing leg pain while walking—should start with treatments such as medication and exercise, ProPublica reported.

Through analyzing Medicare claims records for people who had atherectomies between 2019 and 2022, data journalists from the health analytics group CareSet found that nearly one in four patients underwent the procedure after only a diagnosis of claudication (indicating an early stage of vascular disease).

“As part of the procedure, doctors use a laser or bladed catheter to remove plaque from the patients’ vessel walls,” ProPublica reported. “For treatments conducted in outpatient clinics, Medicare pays generous reimbursements to doctors, who can charge tens of thousands of dollars for procedures done in a single visit.” The newsroom pointed out that such invasive vascular procedures can increase patients’ chances of complications, including amputation or even death.

CareSet researchers found that, while more than 5,000 physicians rarely intervene on patients who appear to have milder vascular disease based on their diagnoses, about 170 other doctors performed half of more of their first-time atherectomies on this type of patient. Also, from 2017 through 2021, the data shows that about 200 doctors were responsible for the majority of atherectomies conducted in the United States and earned altogether nearly $1.5 billion dollars, conducting almost 200,000 procedures.

Doctors named in the data have objected to ProPublica’s analysis for various reasons, including that the use of claims data doesn’t always include key details on patient symptoms and claudication can have a range of severity not fully documented.

Editor’s note: To read ProPublica’s coverage of this story, click here. To read more about the data analysis, click here.