{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:23:17Z","timestamp":1778628197846,"version":"3.51.4"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,6]]},"abstract":"\nObject<\/jats:title>\nSeveral randomized trials have emerged with conflicting data on the overall safety of carotid artery stenting (CAS) in comparison with carotid endarterectomy (CEA). The authors hypothesize that changes in national trends correspond to publication of randomized trials, including an increase in utilization of CAS after publication of trials favorable to CAS (for example, Carotid and Vertebral Artery Transluminal Angioplasty Study [CAVATAS] and Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy [SAPPHIRE]) and decrease in utilization of CAS after publication of trials favorable to CEA (for example, Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis [EVA3-S] and Stent-Supported Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy [SPACE]).<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe Nationwide Inpatient Sample was obtained for the years 1998\u20132008. Individual cases were isolated for principal diagnosis of unilateral or bilateral carotid artery stenosis or occlusion undergoing CEA or CAS. The percentage of CAS for all carotid revascularization procedures was calculated for each year. Perioperative inpatient morbidity, including stroke or death, were calculated and compared.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nThe percentage of patients undergoing CAS increased yearly from the start of the observed period to the end, with the exception of a decrease in 2007. The peak utilization of CAS for carotid artery revascularization procedures was 15% of all cases in 2006. The stroke or death rate was consistent at 5% among all patients undergoing CEA for all years, while the incidence of stroke or death decreased among patients undergoing CAS from 9% in 1998 to 5% in 2008.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nThe practice of CAS in the US is expanding, from less than 3% of all carotid artery revascularization procedures to 13% in 2008. The utilization of CAS was seen to correlate with publication of randomized trials. Utilization nearly doubled in 2005 after publication of the CAS-favorable SAPPHIRE in 2004, and decreased by 22% after publication of the CEA-favorable EVA-3S and SPACE in 2007. With the publication of Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), the authors predict a resultant increase in the rate of CAS for carotid artery disease in the upcoming years.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.3.jns111320","type":"journal-article","created":{"date-parts":[[2012,4,6]],"date-time":"2012-04-06T14:14:26Z","timestamp":1333721666000},"page":"1251-1257","source":"Crossref","is-referenced-by-count":64,"title":["National trends in carotid artery revascularization surgery"],"prefix":"10.3171","volume":"116","author":[{"given":"Travis M.","family":"Dumont","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand I.","family":"Rughani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns111320","series-title":"Stroke","first-page":"336","article-title":"Carotid stenting and angioplasty: a statement for healthcare professionals from the Councils on Cardiovascular Radiology, Stroke, Cardio-Thoracic and Vascular Surgery, Epidemiology and Prevention, and Clinical Cardiology, American Heart Association","volume":"29","author":"Bettmann","year":"1998"},{"key":"b2-jns111320","series-title":"Lancet","first-page":"1729","article-title":"Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial","volume":"357","author":"CAVATAS Investigators","year":"2001"},{"key":"b3-jns111320","series-title":"Lancet","first-page":"985","article-title":"Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial","volume":"357","author":"Ederle","year":"2010"},{"key":"b4-jns111320","series-title":"Med Care","first-page":"8","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"Elixhauser","year":"1998"},{"key":"b5-jns111320","series-title":"Vasc Endovascular Surg","first-page":"165","article-title":"Current management of extracranial carotid artery disease","volume":"40","author":"Faries","year":"2006"},{"key":"b6-jns111320","series-title":"JAMA","first-page":"1993","article-title":"Joint study of extracranial arterial occlusion. 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