Abstract Details

Title Changing Face Of Carotid Revascularization Procedures In The United States

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P14 - Poster Session 14 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-012

Objective We performed this study to determine the changes in utilization of CEA and CAS in United States using nationally representative data.

Background Carotid revascularization procedure, carotid endarterectomy (CEA) and carotid stent placement (CAS), are some of the most common procedures performed in United States and expected to change due to wider adoption of CAS.

Design/Methods We used the National Inpatient Sample (NIS) from 2005 to 2014 to assess the changes in utilization of CEA and CAS over last 10 years in patients with carotid artery stenosis. We analyzed patterns of changes in utilization in various subsets of patients with carotid artery stenosis.

Results A total of 1,186,182 patients underwent carotid revascularization procedures during study period; 1,032,148 (87.1%) and 154,035 (12.9%) were CEA and CAS, respectively. The overall carotid revascularization procedures decreased over last 10 years (11.1% in 2005 to 8.4%in 2014, trend test p <.0001). Carotid revascularization in symptomatic patients increased (7.64% in 2005 to 11.01% in 2014, trend test p <.0001) while it decreased in asymptomatic patients (92.36% in 2006 to 88.99% in 2014, trend test p <.0001). There was an overall decrease in CEA (11.6% in 2005 to 8.3% in 2014, trend test <.0001) while in CAS remained unchanged (8.1% in 2005 to 8.9% in 2014, p=NS). There was a decrease in carotid revascularization procedures in patients aged ≥80 years (19.8% in 2005 to 18.7% in 2014, trend test p <.0001) and CEA (19.6% in 2006 to 18.8% in 2014, trend test P<.0001) and CAS (21.2% in 2006 to 18.6% in 2014, trend test p=<.0001).

Conclusions Although CAS is increasing in a disproportionate manner within patient subgroups in United States, overall carotid revascularization procedures have decreased for unclear reasons.

Authors/Disclosures
Hamza I. Maqsood, MD (Dept of Neurology) PRESENTER	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Saqib A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
	No disclosure on file
	No disclosure on file
Ameer Hassan, DO (Valley Baptist Medical Center)	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
Sairah Bashir, MD, F�鶹��ýӳ��	Dr. Bashir has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic .
	No disclosure on file
Farhan Siddiq, MD	Dr. Siddiq has nothing to disclose.
Camilo R. Gomez, MD, F�鶹��ýӳ�� (University of Missouri)	Dr. Gomez has nothing to disclose.
Muhammad F. Suri, MD (St Cloud Hospital)	Dr. Suri has nothing to disclose.

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