Stenting Outcomes Vary Widely Among U.S. Hospitals

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The risk of death or stroke after carotid artery stenting varies widely among U.S. hospitals, with the odds four times higher at some medical centers than others, new research suggests.

The carotid arteries in the neck supply blood to the brain. After opening a blocked carotid artery, physicians often use a mesh “stent” to keep it open.

Researchers looked at medical records regarding more than 19,000 of these procedures from 188 hospitals between 2005 and 2013.

Overall, they found that an average of 2.4 percent of patients died or suffered a stroke after the procedure, with rates ranging from zero to nearly 19 percent.

Since some hospitals treat sicker patients than others, the researchers adjusted their figures to account for various factors that could throw them off, such as age or prior stroke. Even then, the rate of stroke or death ranged from 1.2 percent to 4.7 percent.

The reasons for this disparity aren’t clear, said the investigators, led by Dr. Beau Hawkins, a cardiologist at the University of Oklahoma Health Sciences Center, and Dr. Robert Yeh, a cardiologist at Massachusetts General Hospital in Boston.

The number of stent procedures performed at a hospital didn’t seem to have an effect on subsequent stroke or death rates, the researchers said.

“Our findings are important because they demonstrate that carotid stenting is being performed with good results across a large number of hospitals in the United States,” they wrote.

“However, our analyses also suggest that some hospitals are achieving better outcomes than others, and it will be important to identify the reasons for this so that all centers offering this therapy can achieve exceptional outcomes,” they added.

The study appears May 18 in the journal JACC: Cardiovascular Interventions..

More information

For more stents, see the U.S. National Heart, Lung, and Blood Institute.

Source: HealthDay

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