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Carotid stenting status quo

This article was originally published in The Gray Sheet

Executive Summary

In a 1July 31 draft decision memo, CMS proposes to keep its current national coverage policy for carotid stenting, which covers stenting with embolic protection at a CMS-approved facility in high-risk patients with symptomatic carotid artery stenosis greater than 70%. The agency says "currently published data is not sufficient to expand coverage beyond the currently covered patient populations" and that it "believes in the importance of completing the ongoing randomized clinical trials and encourages future RCTs with medical therapy comparator arms." In December, a group of professional societies asked CMS to extend coverage to patients at high risk due to defined anatomic factors, and who have either symptomatic carotid artery stenosis of 50% or greater or asymptomatic carotid artery stenosis of 80% or greater. In June, the request was amended to include the Society for Vascular Surgery's recommendation that CMS use national society registries to collect data on carotid stenting instead of the Medicare data submission system (2"The Gray Sheet" June 16, 2008, In Brief)
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