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Division of Vascular and Endovascular Surgery
The Practical Approach – Experience Matters
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Despite clinical trials, minimal evaluation of “real world” experience
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Study Goal: Association between annual volume and experience on outcomes
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Observational study using Medicare administrative database of patients over 65
undergoing carotid stenting
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24701 stents placed over 2 years
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11846 were placed by new operators
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30 day mortality was 1.9%
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Failure to use Embolic Protection was 4.8%
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Median experience was 3 stents per operator per year
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30 day mortality was higher among operators with lower volume (2.1%) vs. high
volume (1.4%) OR 1.9
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Also, higher risk of 30-day mortality if it was done during the operator’s learning
curve OR 1.7
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Conclusion
Among older patients undergoing carotid stenting, lower annual operator
volume and early experience are associated with increased 30-day mortality.
Presentation Title Goes Here
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