Low rates of complications for carotid artery stenting are associated with a high clinician volume of carotid artery stenting and aortic endografting but not with a high volume of percutaneous coronary interventions Invited commentary

摘要

We know that high clinician volume of carotid artery stenting (CAS) is associated with low rates of complications of this procedure. Similarly, one would think that high clinician volume of other endovascular procedures might translate into low rates of complications of CAS, However, why should a low CAS complication rate be associated with high clinician volume of aortic endog-rafting but not with high clinician volume of coronary stenting, as reported in this article? After all, don't both CAS and coronary stenting require high levels of expertise and skill? The authors surmise that in addition to the technical skills necessary to perform CAS, a "cognitive component" of the procedure is essential to achieving optimal outcomes. The authors quote the multispecialty consensus statement on training and credential-ing for CAS qualifications: "physicians who wish to perform carotid stenting should be required to have the cognitive, technical, and clinical skills necessary to care for patients with carotid artery disease."