{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:14:18Z","timestamp":1761808458157,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Carotid endarterectomy (CEA) and carotid artery stenting (CAS) reduce the risk of stroke in patients with severe carotid stenosis. The aim was to compare contemporary treatment trends and outcomes after CEA and CAS between states of Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on data from the Australasian Vascular Audit between 2010 and 2017. The primary endpoint was perioperative stroke or death (S\/D). We also analysed stroke and death independently and revascularization rates per 100\u2009000 population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 15\u2009413 patients underwent carotid revascularization (CEA 14\u2009070; CAS 1343). S\/D rates were similar for CEA and CAS (1.9% versus 1.8%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.37; symptomatic 2.1% versus 2.3%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.12; asymptomatic 1.5% versus 1.1%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.67). Patients \u226580\u2009years (2.7% versus 1.7%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), those who had shunts (2.2% versus 1.7%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03) or surgery in teaching hospitals (2.6% versus 1.4%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02) had higher rates of S\/D after CEA. Patients whose proceduralist used a cerebral protection device had lower S\/D rates after CAS for symptomatic disease (4.8% versus 2.2%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). There was a wide variation in practice between states, where CAS as a proportion of total carotid procedures ranged from 0% to 17%, and a wide variation in outcomes, with rates of S\/D varying between 1.4\u20136.6% for CEA and 0\u20136.7% after CAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Outcomes after CAS are equivalent to CEA when performed by vascular surgeons, however significant variation exists for both choice of revascularization procedure and perioperative outcomes between states. Further investigation is needed to determine whether clinical care pathways should be revised to achieve consistency and quality of outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16757","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T11:35:26Z","timestamp":1616412926000},"page":"1203-1210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends and outcomes in Australian carotid artery revascularization surgery: 2010\u20132017"],"prefix":"10.1111","volume":"91","author":[{"given":"Michelle","family":"Murtidjaja","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-1500","authenticated-orcid":false,"given":"Alexandra O.","family":"Stathis","sequence":"additional","affiliation":[{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon D.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"},{"name":"The Vascular Institute, Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5026-1661","authenticated-orcid":false,"given":"Charles Barry","family":"Beiles","sequence":"additional","affiliation":[{"name":"Australasian Vascular Audit, Australian and New Zealand Society for Vascular Surgery  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1977-0382","authenticated-orcid":false,"given":"Bibombe Patrice","family":"Mwipatayi","sequence":"additional","affiliation":[{"name":"University of Western Australia, School of Surgery  Perth Western Australia Australia"},{"name":"Department of Vascular Surgery Royal Perth Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nedal","family":"Katib","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"},{"name":"The Vascular Institute, Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-6991","authenticated-orcid":false,"given":"Ramon L.","family":"Varcoe","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Department of Surgery Prince of Wales Hospital  Sydney New South Wales Australia"},{"name":"The Vascular Institute, Prince of Wales Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.12.2513"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811123392002"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61197-X"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","unstructured":"Brott TG Hobson RW Howard G Roubin GS Clark WM Brooks W Mackey A Hill MD Leimgruber PP Sheffet AJ Howard VJ.Stenting versus endarterectomy for treatment of carotid\u2010artery stenosis.2010;363:11\u201323.","DOI":"10.1056\/NEJMoa0912321"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505215"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61184-3"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2011.05987.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.04.079"},{"key":"e_1_2_9_10_1","unstructured":"Australian Bureau of Statistics.Australian Historical Population Statistics 2016 cat. no. 3105.0.65.001 2016. 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