BIAS Registry

Created - 16.01.2018

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.