Early Outcomes after Carotid Artery Stenting Compared With Endarterectomy for Asymptomatic Carotid Stenosis

Impact of Hospital Volume on Long‐Term Neurological Outcome in Patients Undergoing Carotid Artery Stenting: A Nationwide Propensity Score‐Matched Study. DOI: 10.1002/ccd.26989

“…Low annual operator volume was shown to be associated with a higher 30-day mortality after CAS in patients aged 65 years or older [5]. In a study including 17,716 carotid endarterectomy and 3,962 CAS procedures in 186 hospitals, however, highvolume hospitals were associated with less periprocedural complications only for endarterectomy, but not for CAS [11]. Furthermore, in another study including 19,381 CAS procedures in 188 hospitals, hospital volume was found to be an insignificant predictor for short-term outcomes after adjustment for case mix [8].…”

“…Prior studies mainly focused on the relationships between hospital or operator volume and periprocedural outcomes [5,8,11]. Low annual operator volume was shown to be associated with a higher 30-day mortality after CAS in patients aged 65 years or older [5].…”

Recent advances in carotid angioplasty and stenting

“…In a recent analysis of 21,678 patients with asymptomatic carotid stenosis treated at 186 U.S. academic centers and their affiliated teaching hospitals, CAS was associated with a >2-fold greater odds of postoperative stroke or death than CEA (4.0% vs. 1.5%, p < 0.001). 47 These studies suggest that the excess of procedural risk of stroke associated with CAS (compared with CEA) may offset the small benefit (if any) of CEA versus medical therapy.…”

Comparison of devices used in carotid artery stenting: A vascular quality initiative analysis of commonly used carotid stents and embolic protection devices

“…Although treatment of symptomatic carotid occlusive disease with either CAS or carotid endarterectomy (CEA) achieves similar long‐term outcomes, higher periprocedural stroke rates have been reported with CAS . In randomized trials of CAS versus CEA, 30‐day stroke and death rates for symptomatic and asymptomatic patients ranged from 6–9% to 2–4%, respectively . Use of embolic protection devices (EPDs) during CAS can reduce the rate of peri‐procedural stroke by as much as 50% .…”

“…been reported with CAS [3][4][5][6][7]. In randomized trials of CAS versus CEA, 30-day stroke and death rates for symptomatic and asymptomatic patients ranged from 6-9% to 2-4%, respectively [7][8][9][10][11][12][13][14]. Use of embolic protection devices (EPDs) during CAS can reduce the rate of peri-procedural stroke by as much as 50% [15][16][17][18].…”