Stenting Shows Higher Risk of Stroke Vs. Cartoid Endarterectomy

Society for Vascular Surgery

To meet reimbursement criteria, candidates for carotid artery stenting (CAS) must either be high-risk surgical patients or be enrolled in a critical trial.

According to researchers from the Beth Israel Deaconess Medical Center's Division of Vascular Surgery in Boston, MA, reimbursement criteria may bias comparisons of CAS and carotid endarterectomy (CEA).

In the December issue of the official publication of the Society for Vascular Surgery®, the Journal of Vascular Surgery®, Marc. L. Schemerhorn, MD, reported that he and fellow researchers wanted to evaluate mortality and stroke  following CAS and CEA stratified by medical high-risk criteria.


"We gathered data from The Nationwide Inpatient Sample between 2004-2007 and identified 56,564 CAS patients and 482,394 CEA patients, all who had a diagnosis of carotid artery stenosis," said Dr. Schemerhorn. "Medical high-risk criteria were identified for each patient including those undergoing a coronary artery bypass and/or valve repair (CABG/V) during the same admission. Symptom status was defined by history of stroke, transient ischemic attack and/or amarosis fugax. The primary outcome was postoperative death, stroke and combined stroke or death, stratified by high-risk vs. non-high-risk status and symptom status."

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