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BIAS Report 2018
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BIAS Report 2018

BIAS Report - Fourth Iliac Angioplasty Study Report - February 2018

Foreword

My thanks to the many people who have contributed to the British Iliac Angioplasty and Stenting (BIAS) registry. The BSIR is very proud to have instigated and supported this project, which is now in its fourth (and nal) report stage. BIAS has been one of the vanguard registries in the United Kingdom. This report joins its three predecessors, and is not only useful for its content, but is also a tribute to all those BSIR members who have taken the time to complete data entry. The society realises that much of this has been given freely, and often in individuals’ spare time. As President, on behalf of The Society, I thank you all for that.

BIAS is (to the best of The Society’s knowledge) the largest iliac artery endovascular intervention registry worldwide, with over 13,000 patients entered over its 16 years of operation. It demonstrates the commitment of the British Interventional Radiology community to ensuring that this index procedure for vascular interventional radiology is delivered safely and is benchmarked for future delivery. We can see that patients experience good outcomes at follow up, which is key. BIAS also provides us with excellent longitudinal information about the way services are delivered, for example the ever-increasing use of day-case facilities.

The BSIR’s rich history in supporting and developing registries is an enviable one. Going forward, The Society encourages members to continue to contribute to the National Vascular Registry (which has taken over the role of documenting iliac intervention from BIAS, as well allowing the recording of more distal peripheral interventions). At the same time, we ask members to consider other areas where data submission by Interventional Radiologists into new registries might establish benchmarks for safe and efective practice. Anyone with enthusiasm and ideas for future registries is encouraged to contact the Registries and Audit Committee via the BSIR website (www.BSIR.org). Many congratulations and thanks to you all. Trevor Cleveland President, British Society of Interventional Radiology.

Many congratulations and thanks to you all.

Trevor Cleveland

President, British Society of Interventional Radiology

Update January 2018

Full report due February 2018

The BSIR BIAS registry of iliac intervention was closed to data collection in 2016 after the expansion of the NVR to include peripheral intervention cases. In total 117 centres have contributed to BIAS since its inception in 2000.

This is the final report from BIAS summarising data on 8294 procedures reported to the registry between 2011 and 2014 inclusive. At peak data entry (2013) nearly 50 patients per week were reported.

The demographics of patients undergoing iliac intervention have not altered substantially since BIAS III. Most interventions (64%) are done for claudication though the proportion of patients undergoing intervention for critical ischaemia increases with increasing age. 1 in 5 procedures are done urgently. There has been a progressive increase in the use of daycase facilities with 44.8% of patients treated via this route (compared with 25% in BIAS III).

Nearly 90% of cases were performed by a consultant radiologist. The number of cases where a trainee was the principal operator has decreased since BIAS III.

54% of lesions were stented and overall 97% of interventions were technically successful (with a residual stenosis of <50%). A closure device was used in 42% of cases, with greater use in daycase patients than inpatients.

Only 3% of patients in the registry had no systemic follow up recorded. Vital status and limb status at discharge was recorded in nn% and nn% respectively. This indicates excellent engagement of the IR community in gathering follow up data.

Overall rates of systemic complication (2.8%), limb complication (4.3%), unplanned additional intervention (1.7%) and death attributable to the procedure (0.1%) were low. Rates of vessel rupture were very low (0.1%) which has implications for service organisation.

Patients experiencing a systemic complication are at a substantially greater risk of death than other patients though the reasons for this are likely to be multifactorial.

Of the centres contributing to the registry, only 3 had rates of complication that lay outside the 99.9% alarm lines on funnel plots. Since BIAS III individual centres (and clinicians) have been able to obtain their specific data which allows reflection, analysis and amendments to services and practice as necessary.

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