The value of comprehensive United States database participation in granting carotid artery stenting privileges in a brave new world

Abstract

This article focuses on the provision of clinical privileges to physicians in the wake of the Centers for Medicare and Medicaid Services updating their National Coverage Decision to cover all carotid stenting procedures. This article emphasizes that participation in nationwide data registries fulfills quality monitoring and improvement requirements under the Centers for Medicare and Medicaid Services National Coverage Decision and, therefore, should be a mandatory requirement in credentialing decisions for all carotid artery stenting procedures at an institutional level. Data from registries such as the Vascular Quality Initiative or National Surgery Quality Improvement Program have been instrumental in comparisons of outcomes and learning curves between carotid procedures. Credentialing guidelines, as outlined by medical societies, already reflect crucial evidence-based differences in learning curves and in volume-outcomes relationships which have critical relevance to the quality of care for patients undergoing carotid stenting procedures.