Abstract 14764: Potential Heterogeneity in the Performance of Carotid Artery Stenting Relative to Carotid Endarterectomy Among Subgroups of Medicare Beneficiaries in Routine Clinical Practice

Introduction: The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) suggested that the relative performance of carotid artery stenting (CAS) and carotid endarterectomy (CEA) may differ across subgroups of patients defined by age. Objective: To compare outcomes following CAS relative to CEA in routine clinical practice among subgroups of Medicare patients defined by demographic and clinical characteristics. Methods: We linked Medicare data (2000-2009) to the Society for Vascular Surgery’s Vascular Registry (SVS-VR; 2005-2008) and to the NCDR® Carotid Artery Revascularization and Endarterectomy Registry (CARE; 2006-2008/9). Medicare patients aged ≥66 years undergoing CAS or CEA were followed from the procedure date for the outcomes of death or a composite endpoint consisting of death, stroke/transient ischemic attack, or peri-procedural myocardial infarction. We compared CAS to CEA using Cox regression in strata of Medicare patients defined by age (≤80/>80), sex, symptomatic status, degree...