A retrospective cohort study was conducted using the HCUP-AHRQ National Readmission Database (NRD) to compare outcomes between intravascular ultrasound (IVUS) guided peripheral vascular intervention (PVI) and non-IVUS guided PVI. The primary outcome, major amputation at 6 months post-hospitalization, was compared between cohorts. Propensity score inverse probability of treatment weighting matched confounders. Results indicate similar amputation risks at 6 months between PVI with IVUS and without IVUS. Subgroup analysis showed significantly lower amputation rates with IVUS in patients experiencing rest pain, undergoing iliac intervention, or receiving drug-eluting stent implantation. This nationwide observational study suggests no overall difference in major amputation rates with IVUS use during PVI, though it may confer benefits in specific patient subsets.
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