The association of Carotid Revascularization Endarterectomy versus Stent Trial (CREST) and Centers for Medicare and Medicaid Services Carotid Guideline Publication on utilization and outcomes of carotid stenting among "high-risk" patients

Journal of Vascular Surgery
Gregory G SalzlerMohammad H Eslami

Abstract

Since the 2004 approval by the United States Food and Drug Administration of carotid artery stenting (CAS), there have been two seminal publications about CAS reimbursement (Centers for Medicare and Medicaid Services guidelines; 2008) and clinical outcomes (Carotid Revascularization Endarterectomy versus Stent Trial [CREST]; 2010). We explored the association between these publications and national trends in CAS use among high-risk symptomatic patients. The most recent congruent data sets of the Nationwide Inpatient Sample (NIS) were queried for patients undergoing carotid revascularization. The sample was limited to include only patients who were defined as "high-risk" if they had a Charlson Comorbidity Score of ≥3.0. Subgroup analyses were performed of high-risk patients with symptomatic carotid stenosis. Utilization proportions of CAS were calculated quarterly from 2005 to 2011 for NIS. Three time intervals related to Centers for Medicare and Medicaid Services guidelines and CREST publication were selected: 2005 to 2008, 2008 to 2010, and after 2010. Logistic regression with piecewise linear trend for time was used to estimate different trends in CAS use for the overall high-risk sample and for neurologically asymptomatic an...Continue Reading

Citations

Nov 2, 2018·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·T Schmitz-Rixen, R T Grundmann
Mar 9, 2019·The Journal of Cardiovascular Surgery·Patric LiangMarc L Schermerhorn
Dec 19, 2019·Stroke; a Journal of Cerebral Circulation·Tyler S ColeAndrew F Ducruet
Aug 5, 2020·The Cochrane Database of Systematic Reviews·Anik GiguèreJosé Massougbodji
Apr 1, 2020·Continuum : Lifelong Learning in Neurology·Michael F Waters
Feb 9, 2021·Annals of Vascular Surgery·Ava D MandelbaumPeyman Benharash
Jul 15, 2020·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Thomas W ChengJeffrey J Siracuse

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