Asunto(s)
Procedimientos Endovasculares/métodos , Isquemia/cirugía , Accidente Cerebrovascular/cirugía , Ensayos Clínicos como Asunto , Humanos , Investigación Interdisciplinaria , Isquemia/epidemiología , Evaluación del Resultado de la Atención al Paciente , Mejoramiento de la Calidad , Sociedades Médicas , Accidente Cerebrovascular/epidemiología , Estados Unidos/epidemiologíaRESUMEN
Carotid artery stenting (CAS) has become an integral part of the therapeutic armamentarium offered by cardiovascular medicine programs for the prevention of stroke. The purpose of this expert consensus statement is to provide physician training and credentialing guidance to facilitate the safe and effective incorporation of CAS into clinical practice within these programs. Since publication of the 2005 Clinical Competence Statement on Carotid Stenting, there has been substantial device innovation, publication of numerous clinical trials and observational studies, accumulation of extensive real-world clinical experience and widespread participation in robust national quality improvement initiatives [5]. Collectively, these advances have led to substantial evolution in the selection of appropriate patients, as well as in the cognitive, technical and clinical skills required to perform safe and effective CAS. Herein, we summarize published guidelines, describe training pathways, outline elements of competency, offer strategies for tracking outcomes, specify facility, equipment and personnel requirements, and propose criteria for maintenance of CAS competency.