Abstract 4537: Relationship Between Procedure Indications and Outcomes of Carotid Artery Stenting: Preliminary Results from the CARE Registry

Abstract

Background: In 2007 a consortium of specialty societies developed and published a clinical expert consensus document (CECD) on carotid artery stenting (CAS). This CECD listed suggested indications for CAS based on the presence of symptoms, stenosis severity, and the presence of features that increase the surgical risk of carotid endarterectomy. The National Cardiovascular Data Registry, in conjunction with multiple specialty societies, established the CARE (Carotid Artery Revascularization and Endarterectomy) Registry to provide a comprehensive national database characterizing both forms of carotid revascularization. Methods: CARE employs written definitions, a data dictionary, standardized data collection tools, and quality control checks. We constructed an algorithm that categorized each procedure as conforming to a Recommended Indication (RECC) if it met the indications criteria in the CECD, or as not recommended (NOTRECC) if it didn’t. Patient characteristics and outcomes of these 2 groups were compared. Results: There were 3118 CAS procedures submitted from 107 participating centers for the period 01/2007 through 03/2008. Of these, 2397 (77%) were RECC, while 721 (23%) were NOTRECC. Clinical profiles in the NOTRECC group were more favorable, but overall outcomes were similar. (See Table ) Conclusions: CAS procedures categorized as NOTRECC by CECD criteria accounted for approximately one-fourth of submissions to the CARE Registry. Clinical profiles were different. Outcomes were similar.