Carotid stenting was associated with much higher than expected 2-year mortality in the Medicare population, a national analysis found.

That rate was 32% in the CMS carotid artery stenting database (CAS-D) from 2005 to 2009, Soko Setoguchi, MD, DrPH, of the Duke Clinical Research Institute, and colleagues reported online in JAMA Neurology.

In the CREST trial, mortality was 11.3% after a median follow-up of 2.5 years. In SAPPHIRE, it was 20% after 3 years. The researchers concluded that those trials might have limited generalizability to the Medicare population and called for real-world effectiveness studies comparing the percutaneous treatment to surgery and to medical management.


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