What are the indications for CAS to treat atherosclerotic disease of the carotid artery?

Updated: Oct 04, 2018
  • Author: Jake F Hemingway, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Advances in CAS notwithstanding, CEA remains the standard of care. Currently, the Centers for Medicare and Medicaid Services (CMS) has approved reimbursement for CAS only in the following patients [19] :

  • Symptomatic patients with high-grade stenosis (≥70%) who are considered to be at high risk for CEA, provided that FDA-approved CAS systems and FDA-approved or -cleared embolic protection devices are used
  • Symptomatic patients with 50-70% stenosis who are considered to be at high risk for CEA, in accordance with category B IDE clinical trials regulation, as a routine cost under the clinical trials policy, or in accordance with the National Coverage Determination on postapproval studies
  • Patients who are at high risk for CEA and have asymptomatic carotid stenosis of 80% or higher, in accordance with category B IDE clinical trials regulation, as a routine cost under the clinical trials policy, or in accordance with the National Coverage Determination on postapproval studies

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