Document Detail

Cost implications of more widespread carotid artery stenting consistent with the American College of Cardiology/American Heart Association guideline.
MedLine Citation:
PMID:  22188738     Owner:  NLM     Status:  MEDLINE    
The recent American College of Cardiology/American Heart Association guideline recommended carotid artery stenting (CAS) as an alternative to carotid endarterectomy (CEA) for symptomatic patients. This and the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) form the basis for seeking more liberalized indications and reimbursement for CAS. For the years 2005-2007, >130,000 carotid interventions/year were performed, 88.6% of which were CEAs and 11.4% were CAS. For the same years, each CAS procedure had on average $12,000-$13,500 more expensive mean total hospital charges than each CEA. If the percentages of CAS and CEA had been equal (ie, 50% CAS and 50% CEA), this would translate into an additional $2,000,000,000 in charges for these 3 years. It seems unreasonable to approve enhanced reimbursement for CAS at this time, especially since the large incremental costs would go to support CAS procedures that are inferior in most symptomatic patients and possibly unnecessary in most asymptomatic patients.
Kosmas I Paraskevas; Wesley S Moore; Frank J Veith
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Publication Detail:
Type:  Journal Article     Date:  2011-12-20
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-23     Completed Date:  2012-03-12     Revised Date:  2012-10-19    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  585-7     Citation Subset:  IM    
Copyright Information:
Published by Mosby, Inc.
Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.
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MeSH Terms
American Heart Association / economics*
Angioplasty / economics*,  instrumentation*,  standards
Cardiology / economics*,  standards
Carotid Stenosis / economics*,  therapy*
Cost-Benefit Analysis
Endarterectomy, Carotid / economics*,  standards
Guideline Adherence
Health Care Costs*
Hospital Charges
Insurance, Health, Reimbursement
Patient Selection
Practice Guidelines as Topic
Societies, Medical / economics*,  standards
Stents / economics*
United States
Unnecessary Procedures / economics
Comment In:
J Vasc Surg. 2012 Sep;56(3):899   [PMID:  22917055 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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