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Published on: July 9, 2020

Creating accountable care for carotid angioplasty and stenting: A multidisciplinary carotid revascularization board

Maximilian K Kole1, Muhib Khan, Horia Marin

  • 1Department of Radiology and Neurosurgery, Henry Ford Hospital, Detroit, MI, USA.

Surgical Neurology International
|March 6, 2013
PubMed

Insights

A multidisciplinary board for carotid artery stenting (CAS) is feasible and beneficial. This approach improves patient care through oversight, standardization, and collaboration, reducing complications and enhancing outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Neurology
  • Cardiology

Background:

  • Assessed the feasibility of a mandated multidisciplinary carotid revascularization board (MDCB).
  • The MDCB aims to review, approve, and monitor all carotid artery stenting (CAS) procedures and outcomes.
  • Ensures appropriate CAS referral through evidence-based consensus.

Purpose of the Study:

  • To evaluate the feasibility and advantages of a mandated MDCB.
  • To establish a model for accountable care in carotid revascularization.
  • To improve institutional oversight and standardize CAS procedures.

Main Methods:

  • Established a board comprising vascular surgeons, cardiologists, interventional neuroradiologists, neurosurgeons, and neurologists.
  • Conducted weekly meetings for evidence-based consensus recommendations.
  • Reviewed and approved all CAS procedures at the institution.

Main Results:

  • The MDCB successfully reviewed and approved all CAS procedures.
  • For 69 high-risk patients (mean age 70.5, 79% stenosis), periprocedural complications included 2.7% death, 2.7% major stroke, 2.7% minor stroke, and 2.7% MI.
  • At 1 year, ipsilateral stroke was 8.1% and neurovascular death was 2.7%. At 21 months, all-cause mortality was 18.8% and stroke incidence was 14.5%.

Conclusions:

  • A mandated MDCB is feasible and advantageous in clinical practice.
  • The MDCB provides institutional oversight, operator credentialing, and quality review.
  • This model promotes standardized care, cost containment, and collaborative practice.
Abstract

Keywords:
Carotid angioplastymultidisciplinary review boardstenting

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