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IP131. Transfemoral Carotid Angioplasty and Stenting With Embolic Protection: A 7-year Retrospective Analysis of a Single-Center Experience
Carotid angioplasty and stenting (CAS) is an excellent, often superior, alternative to carotid endarterectomy (CEA). When performed by experienced operators, both are equivalent in periprocedural risk and stroke prevention. Widespread adoption of CAS in the United States has been impeded by reimbursement regulations mandated by the Centers for Medicare and Medicaid Services (CMS) that favor CEA over CAS for patients with asymptomatic carotid disease. This policy has led to decreased CAS volumes and an increase in percentages of patients receiving CAS for symptomatic vs asymptomatic disease.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Michael B. Silva, Garold Motes, Zulfiqar Faisal. Cheema, Grant Fankhauser, Nikita Tihonov, Jennifer Worsham, Kaled Diab, Charlie Cheng Tags: IP: Interactive Poster Session Source Type: research

Trends in Carotid Revascularization Procedures —Reply
In Reply Dr Hussain and colleagues point out interesting comparisons in carotid revascularization trends in Ontario, Canada, and in the US Medicare population, including similar 30-day stroke or death outcomes after carotid endarterectomy and stenting. We agree that differing reimbursement policies in the United States and Canada may account for differing patterns of carotid stenting after 2006. A noted difference is the lower receipt of procedures among symptomatic patients in the United States vs Ontario. However, such variation is expected because the approach to asymptomatic treatment has been shown to vary among Western countries.
Source: JAMA - January 16, 2018 Category: General Medicine Source Type: research

VESS05. In-Hospital Outcomes of Transcarotid Artery Revascularization and Carotid Endarterectomy in the Society for Vascular Surgery Vascular Quality Initiative
This study compares initial in-hospital outcomes of CEA and TCAR using the Society for Vascular Surgery (SVS) Vascular Quality Initiative TCAR Surveillance Project done in collaboration with the Centers for Medicare and Medicaid Services to create more information for future coverage decisions.
Source: Journal of Vascular Surgery - May 22, 2018 Category: Surgery Authors: Marc L. Schermerhorn, Hanaa Dakour Aridi, Vikram S. Kashyap, Grace J. Wang, Brian Nolan, Jack Cronenwett, Jens Eldrup-Jorgensen, Mahmoud B. Malas Source Type: research

Expansion of Transcarotid Artery Revascularization to Standard Risk Patients for Treatment of Carotid Artery Stenosis
Transcarotid artery revascularization (TCAR) is currently reimbursed by the Centers for Medicare and Medicaid Services for treatment of medically and anatomically high-risk patients. TCAR has been found to be associated with equivalent stroke/death outcomes compared with carotid endarterectomy (CEA) for high-risk patients. However, the safety profile of TCAR in standard-risk patients is currently not well-defined and has limited its expansion of use in this patient population.
Source: Journal of Vascular Surgery - August 24, 2021 Category: Surgery Authors: Patric Liang, Jack Cronenwett, Eric Secemsky, Jens Eldrup-Jorgensen, Mahmoud Malas, Grace J. Wang, Brian Nolan, Vikram S. Kashyap, Raghu L. Motaganahalli, Marc L. Schermerhorn Tags: S2: Plenary Session 2 Source Type: research

Rules of engagement: The delicate dance between vascular surgeons, industrial partners, and patient outcomes
In 1953, Michael E. DeBakey performed the first carotid endarterectomy successfully. It would be almost 60  years until a new technique disrupted the carotid world with as much furor. In 2012, transcarotid artery revascularization (TCAR) burst onto the scene. With its minimally invasive, hybrid appeal and equivalency to carotid endarterectomy stroke risk, TCAR quickly won the hearts of many vascular sur geons. The update of TCAR technology was rapid, increasing dramatically at 15% annually, with a real jolt coming in 2016 when the Centers for Medicare& Medicaid Services allowed coverage for TCAR under the existing nationa...
Source: Journal of Vascular Surgery - November 19, 2021 Category: Surgery Authors: Anahita Dua Tags: Invited commentary Source Type: research

Long-Term Outcomes of Carotid Endarterectomy vs. Transfemoral Carotid Stenting in a Medicare-Matched Database
Carotid endarterectomy is associated with lower risk of perioperative stroke compared to transfemoral carotid artery stenting in the treatment of carotid artery stenosis. However, there is discrepancy in data regarding long-term outcomes. We aimed to compare long-term outcomes of carotid endarterectomy vs transfemoral carotid artery stenting using the Medicare-matched Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network database.
Source: Journal of Vascular Surgery - August 25, 2023 Category: Surgery Authors: Kevin S. Yei, Claire Janssen, Nadin Elsayed, Isaac Naazie, Art Sedrakyan, Mahmoud B. Malas Source Type: research

Long-term outcomes of carotid endarterectomy vs transfemoral carotid stenting in a Medicare-matched database
Carotid endarterectomy (CEA) is associated with lower risk of perioperative stroke compared with transfemoral carotid artery stenting (TFCAS) in the treatment of carotid artery stenosis. However, there is discrepancy in data regarding long-term outcomes. We aimed to compare long-term outcomes of CEA vs TFCAS using the Medicare-matched Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network database.
Source: Journal of Vascular Surgery - August 25, 2023 Category: Surgery Authors: Kevin S. Yei, Claire Janssen, Nadin Elsayed, Isaac Naazie, Art Sedrakyan, Mahmoud B. Malas Source Type: research

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