Editor's Choice - Carotid Stenosis Treatment: Variation in International Practice Patterns.

2.50
Hdl Handle:
http://hdl.handle.net/2336/620221
Title:
Editor's Choice - Carotid Stenosis Treatment: Variation in International Practice Patterns.
Authors:
Venermo, M; Wang, G; Sedrakyan, A; Mao, J; Eldrup, N; DeMartino, R; Mani, K; Altreuther, M; Beiles, B; Menyhei, G; Danielsson, G; Thomson, I; Heller, G; Setacci, C; Björck, M; Cronenwett, J
Citation:
Editor's Choice - Carotid Stenosis Treatment: Variation in International Practice Patterns. 2017, 53 (4):511-519 Eur J Vasc Endovasc Surg
Issue Date:
Apr-2017
Abstract:
The aim was to determine current practice for the treatment of carotid stenosis among 12 countries participating in the International Consortium of Vascular Registries (ICVR).; Data from the United States Vascular Quality Initiative (VQI) and the Vascunet registry collaboration (including 10 registries in Europe and Australasia) were used. Variation in treatment modality of asymptomatic versus symptomatic patients was analysed between countries and among centres within each country.; Among 58,607 procedures, octogenarians represented 18% of all patients, ranging from 8% (Hungary) to 22% (New Zealand and Australia). Women represented 36%, ranging from 29% (Switzerland) to 40% (USA). The proportion of carotid artery stenting (CAS) among asymptomatic patients ranged from 0% (Finland) to 26% (Sweden) and among symptomatic patients from 0% (Denmark) to 19% (USA). Variation among centres within countries for CAS was highest in the United States and Australia (from 0% to 80%). The overall proportion of asymptomatic patients was 48%, but varied from 0% (Denmark) to 73% (Italy). There was also substantial centre level variation within each country in the proportion of asymptomatic patients, most pronounced in Australia (0-72%), Hungary (5-55%), and the United States (0-100%). Countries with fee for service reimbursement had higher rates of treatment in asymptomatic patients than countries with population based reimbursement (OR 5.8, 95% CI 4.4-7.7).; Despite evidence about treatment options for carotid artery disease, the proportion of asymptomatic patients, treatment modality, and the proportion of women and octogenarians vary considerably among and within countries. There was a significant association of treating more asymptomatic patients in countries with fee for service reimbursement. The findings reflect the inconsistency of the existing guidelines and a need for cooperation among guideline committees all over the world.
Description:
To access publisher's full text version of this article click on the hyperlink below
Additional Links:
http://ac.els-cdn.com/S1078588417300606/1-s2.0-S1078588417300606-main.pdf?_tid=377a180c-504b-11e7-986e-00000aacb35d&acdnat=1497367144_5e2bed3205dbb3c0c6868b1f827a9cc5
Rights:
Archived with thanks to European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

Full metadata record

DC FieldValue Language
dc.contributor.authorVenermo, Men
dc.contributor.authorWang, Gen
dc.contributor.authorSedrakyan, Aen
dc.contributor.authorMao, Jen
dc.contributor.authorEldrup, Nen
dc.contributor.authorDeMartino, Ren
dc.contributor.authorMani, Ken
dc.contributor.authorAltreuther, Men
dc.contributor.authorBeiles, Ben
dc.contributor.authorMenyhei, Gen
dc.contributor.authorDanielsson, Gen
dc.contributor.authorThomson, Ien
dc.contributor.authorHeller, Gen
dc.contributor.authorSetacci, Cen
dc.contributor.authorBjörck, Men
dc.contributor.authorCronenwett, Jen
dc.date.accessioned2017-06-13T15:28:52Z-
dc.date.available2017-06-13T15:28:52Z-
dc.date.issued2017-04-
dc.date.submitted2017-
dc.identifier.citationEditor's Choice - Carotid Stenosis Treatment: Variation in International Practice Patterns. 2017, 53 (4):511-519 Eur J Vasc Endovasc Surgen
dc.identifier.issn1532-2165-
dc.identifier.pmid28274551-
dc.identifier.doi10.1016/j.ejvs.2017.01.012-
dc.identifier.urihttp://hdl.handle.net/2336/620221-
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractThe aim was to determine current practice for the treatment of carotid stenosis among 12 countries participating in the International Consortium of Vascular Registries (ICVR).en
dc.description.abstractData from the United States Vascular Quality Initiative (VQI) and the Vascunet registry collaboration (including 10 registries in Europe and Australasia) were used. Variation in treatment modality of asymptomatic versus symptomatic patients was analysed between countries and among centres within each country.en
dc.description.abstractAmong 58,607 procedures, octogenarians represented 18% of all patients, ranging from 8% (Hungary) to 22% (New Zealand and Australia). Women represented 36%, ranging from 29% (Switzerland) to 40% (USA). The proportion of carotid artery stenting (CAS) among asymptomatic patients ranged from 0% (Finland) to 26% (Sweden) and among symptomatic patients from 0% (Denmark) to 19% (USA). Variation among centres within countries for CAS was highest in the United States and Australia (from 0% to 80%). The overall proportion of asymptomatic patients was 48%, but varied from 0% (Denmark) to 73% (Italy). There was also substantial centre level variation within each country in the proportion of asymptomatic patients, most pronounced in Australia (0-72%), Hungary (5-55%), and the United States (0-100%). Countries with fee for service reimbursement had higher rates of treatment in asymptomatic patients than countries with population based reimbursement (OR 5.8, 95% CI 4.4-7.7).en
dc.description.abstractDespite evidence about treatment options for carotid artery disease, the proportion of asymptomatic patients, treatment modality, and the proportion of women and octogenarians vary considerably among and within countries. There was a significant association of treating more asymptomatic patients in countries with fee for service reimbursement. The findings reflect the inconsistency of the existing guidelines and a need for cooperation among guideline committees all over the world.en
dc.description.sponsorshipUS Food and Drug Administrationen
dc.language.isoenen
dc.publisherW.B. Saundersen
dc.relation.urlhttp://ac.els-cdn.com/S1078588417300606/1-s2.0-S1078588417300606-main.pdf?_tid=377a180c-504b-11e7-986e-00000aacb35d&acdnat=1497367144_5e2bed3205dbb3c0c6868b1f827a9cc5en
dc.rightsArchived with thanks to European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgeryen
dc.subjectÆðasjúkdómaren
dc.subjectSlagæðaren
dc.subjectVAS12en
dc.subject.meshCarotid Stenosisen
dc.titleEditor's Choice - Carotid Stenosis Treatment: Variation in International Practice Patterns.en
dc.typeArticleen
dc.contributor.department1 University Hospital, Helsinki, Finland. Electronic address: Maarit.venermo@hus.fi. 2 Hospital of the University of Pennsylvania, Division of Vascular Surgery, Philadelphia, PA, USA. 3 Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA. 4 Aarhus University Hospital, Arhus, Denmark. 5 Mayo Clinic, Rochester, MN, USA. 6 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. 7 Department of Vascular Surgery, St Olavs Hospital, Trondheim, Norway. 8 Australian and New Zealand Society for Vascular Surgery, East Melbourne, Australia. 9 Department of Vascular Surgery, University Pecs Medical School, Pecs, Hungary. 10 National University Hospital of Iceland, Department of Surgery, Reykjavik, Iceland. 11 Vascular Surgery, Dunedin School of Medicine, Dunedin Hospital, Dunedin, New Zealand. 12 Department of Surgery, Kantonsspital Graubünden, Chur, Switzerland. 13 Vascular and Endovascular Surgery Unit, Department of Medicine, Surgery and Neuroscience University of Siena, Italy. 14 Section of Vascular Surgery, Dartmouth-Hitchcock Medical Centre, Lebanon, NH, USA.en
dc.identifier.journalEuropean journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgeryen
dc.rights.accessNational Consortium - Landsaðganguren

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