An analysis of operator experience and outcomes raises questions about who should perform carotid artery stenting, and who should undergo it.
Carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy (CEA) for reducing the risk for stroke from carotid stenosis, although their comparability remains controversial. CEA must be performed by experienced surgeons with low complication rates to provide a benefit over medical management. To see whether operator experience similarly affects outcomes of CAS, investigators examined Medicare data on CAS from 2005 through 2007.
Approximately 25,000 CAS procedures were performed on Medicare beneficiaries, half in asymptomatic patients. The overall 30-day mortality after CAS was nearly 2%, compared with about 1% in randomized trials. High-volume providers (≥24 procedures per year) were significantly more likely to ope…
Reviewing Author
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)