Journal of Vascular Surgery
Volume 46, Issue 6 , Pages 1112-1118.e1 , December 2007

Carotid endarterectomy was performed with lower stroke and death rates than carotid artery stenting in the United States in 2003 and 2004

Podium presentation at the annual meeting of the Society for Vascular Surgery, Baltimore, Md, Jun 7-10, 2007.

  • James T. McPhee, MD

      Affiliations

    • Department of Surgery, University of Massachusetts Medical School, Worcester, Mass
    • ,
  • Joshua S. Hill, MD, MS

      Affiliations

    • Division of Vascular Surgery, University of Massachusetts Medical School, Worcester, Mass.
    • ,
  • Rocco G. Ciocca, MD

      Affiliations

    • Division of Vascular Surgery, University of Massachusetts Medical School, Worcester, Mass.
    • ,
  • Louis M. Messina, MD

      Affiliations

    • Division of Vascular Surgery, University of Massachusetts Medical School, Worcester, Mass.
    • ,
  • Mohammad H. Eslami, MD

      Affiliations

    • Division of Vascular Surgery, University of Massachusetts Medical School, Worcester, Mass.
    • Corresponding Author InformationReprint requests: Mohammad H. Eslami, MD, University of Massachusetts Medical School, Department of Vascular Surgery, 55 Lake Ave N, Worcester, MA 01655.

Received 4 June 2007 ,Accepted 18 August 2007.

References 

  1. U.S. Department of Health and Human ServicesFood and Drug Administration. ACCULINK review. http://www.fda.gov/cdrh/pdf4/p040012a.pdf2007;Accessed Aug 14
  2. North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445
  3. European Carotid Surgery Trialists’ Collaborative Group. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. Lancet. 1991;337:1235
  4. Halliday A, Mansfield A, Marro J, Peto C, Peto R, Potter J, et al. MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomized controlled trial. Lancet. 2004;363:1491–1502
  5. Executive committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–1428
  6. Nowygrod R, Egorova N, Greco G, Anderson P, Gelijns A, Moskowitz A, et al. Trends, complications, and mortality in peripheral vascular surgery. J Vasc Surg. 2006;43:205–216
  7. Yadav JS, Wholey MH, Kuntz RE, Fayad R, Katzen BT, Mishkel GJ, et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–1501
  8. Gray WA, Hopkins LN, Yadav S, Davis T, Wholey M, Atkinson R, et al. Protected carotid stenting in high-surgical-risk patients: the ARCHeR results. J Vasc Surg. 2006;44:258–269
  9. Naylor AR, Golledge J. High risk plaque, high risk patient, or high risk procedure?. Eur J Vasc Endovasc Surg. 2006;32:557–560
  10. Coward LJ, Featherstone RL, Brown MB. Safety and efficacy of endovascular treatment of carotid artery stenosis compared with carotid endarterectomy: a Cochrane systematic review of the randomized evidence. Stroke. 2005;36:905–911
  11. Society for Vascular Surgery. Re: Reconsideration of carotid artery stenting coverage guidance CAG-00085R3 [letter to Centers for Medicare and Medicaid Services]. http://www.vascularweb.org/_CONTRIBUTION_PAGES/Reimbursement/CMS_Letter.pdf2007;Accessed Aug 14
  12. Naylor RA. Regarding “Protected carotid stenting in high-surgical-risk patients: The ARCHeR results.”. J Vasc Surg. 2007;45:222–223
  13. The SPACE Collaborative Group. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomized non-inferiority trial. Lancet. 2006;368:1239–1247
  14. Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1660–1671
  15. Nationwide Inpatient Sample (NIS). Overview. http://www.hcup-us.ahrq.gov/nisoverview.jsp2007;Accessed Aug 14
  16. Dimick JB, Welch HG, Birkmeyer JD. Surgical mortality as an indicator of hospital quality: the problem with small sample size. JAMA. 2004;292:847–851
  17. Kotwall CA, Maxwell GJ, Brinker CC, Koch GG, Covington DL. National estimates of mortality rates for radical pancreaticoduodenectomy in 25,000 patients. Ann Surg Oncol. 2002;9:847–854
  18. Timaran CH, Veith FJ, Rosero EB, Modrall JG, Arko FR, Clagett GP, et al. Endovascular aortic aneurysm repair in patients with the highest risk and in-hospital mortality in the United States. Arch Surg. 2007;142:52–54discussion 524-5
  19. US Department of Health and Human Services. International classification of diseases, 9th revision, clinical modification. Washington, DC: US Government Printing Office; 1998;
  20. Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36:3–5
  21. Cowan JA, Dimick JB, Thompson BG, Stanley JC, Upchurch GR. Surgeon volume as an indicator of outcomes after carotid endarterectomy: an effect independent of specialty practice and hospital volume. J Am Coll Surg. 2002;195:814–821
  22. Cao P, De Rango P, Verzini F, Maselli A, Norgiolini L, Giordano G. Outcome of carotid stenting versus endarterectomy (A case-control study). Stroke. 2006;37:1221–1226
  23. Mackey WC. Regarding protected carotid stenting. J Vasc Surg. 2006;44:258–268
  24. Westvik HH, Westvik TS, Maloney SP, Kudo FA, Muto A, Leite JO, et al. Hospital-based factors predict outcome after carotid endarterectomy. J Surg Res. 2006;134:74–80
  25. Debing E, Van den Brande P. Does the type, number or combinations of traditional cardiovascular risk factors affect early outcome after carotid endarterectomy. Eur J Vasc Endovasc Surg. 2006;31:622–626
  26. Iezzoni LI, Foley SM, Daley J, Hughes J, Fisher ES, Heeren T. Comorbidities, complications, and coding bias (Does the number of diagnosis codes matter in predicting in-hospital mortality?). JAMA. 1992;267:2197–2203
  27. Jencks SF, Williams DK, Kay TL. Assessing hospital-associated deaths from discharge data: the role of length of stay and comorbidities. JAMA. 1988;260:2240–2246

 Competition of interest: none.

 Additional material for this article may be found online at www.jvascsurg.org.

PII: S0741-5214(07)01358-4

doi: 10.1016/j.jvs.2007.08.030

Journal of Vascular Surgery
Volume 46, Issue 6 , Pages 1112-1118.e1 , December 2007

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