Procedures in Office Settings
Revascularization for Peripheral Artery Disease
Minimally invasive endovascular procedures that restore blood flow to the legs — performed safely in office-based settings at a fraction of hospital costs.
2.5x
more costly when performed in a hospital outpatient department vs. office-based setting
Understanding Peripheral Artery Disease
Peripheral Artery Disease (PAD) in the lower extremities is the narrowing or blocking of the arteries that carry blood from the heart to the legs. Symptoms include impaired walking function, rest pain, nonhealing wounds, gangrene, and limb loss — all of which can severely impact daily life.
For patients whose symptoms reach a debilitating level, an endovascular revascularization procedure may be recommended. Research shows that chronic limb-threatening ischemia (CLTI) carries a five-year mortality rate nearly double that of all cancers combined.
Office-based care makes a difference: Many endovascular procedures are minimally invasive and can be safely performed in ambulatory settings, including physicians' offices — improving access and significantly reducing costs. Revascularization procedures performed in a hospital outpatient department can be more than several times more costly to Medicare than when done in an office-based setting.
Arterial Endovascular Revascularization Techniques
Modern imaging technologies, interventional techniques, and specialized equipment allow
physicians to perform these procedures with precision and safety outside of hospital environments.
Angioplasty
A small balloon is inserted into the vessel and expanded to restore normal blood flow through the blocked artery.
Atherectomy
Plaque build-up within the vessel is removed using a specialized catheter equipped with a sharp blade or laser.
Stenting
A mesh tube or stent is expanded within the vessel to keep it open and maintain proper blood flow after revascularization.
Research & Outcomes
Quality
Procedural and 3-Year Outcomes of Peripheral Vascular Interventions in Office-Based Labs (LIBERTY 360)
Observing more than 700 patients over both short- and long-term follow-up found no significant differences in clinical outcomes based on site of service — confirming office-based labs are equivalent to hospitals for these procedures.
Health & Equity
Racial & Ethnic Disparities in
Peripheral Artery Disease
Black Americans face delayed detection and treatment of PAD, are less likely to receive limb salvage procedures, and have higher mortality from major cardiovascular events. Expanding office-based access is a key lever for closing this gap.
Racial & Ethnic Disparities in Peripheral Artery Disease
Access to revascularization is not equal across all communities. Research consistently shows that Black Americans and other minority groups face significant disparities in both detection and treatment of PAD — with life-altering consequences.
Key findings: Racial & Ethnic Disparities in PAD (Hackler et al., 2021)
Black people in the U.S. experience significant inequities at every stage of PAD care:
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More likely to experience delayed detection and treatment of PAD.
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Less likely to be treated with optimal medical therapy.
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More likely to undergo amputation and less likely to receive limb salvage procedures.
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Face a higher mortality rate from major cardiovascular events
Office-based limb salvage centers improve access to limb-saving care — particularly for rural and undeserved areas.
Office-Based Limb Salvage Centers
