Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar;79(3):704-707.
doi: 10.1016/j.jvs.2023.10.050. Epub 2023 Nov 3.

Decision aids for patients with carotid stenosis

Brianna M Krafcik  1 , Isabel A Jarmel  2 , Jocelyn M Beach  3 , Bjoern D Suckow  3 , Jennifer A Stableford  3 , David H Stone  3 , Philip P Goodney  3 , Jesse A Columbo  3
Affiliations
Review

Decision aids for patients with carotid stenosis

Brianna M Krafcik et al. J Vasc Surg. 2024 Mar.

Abstract

Background: Shared decision-making tools have been underused by clinicians in real-world practice. Changes to the National Coverage Determination by Medicare for carotid stenting greatly expand the coverage for patients, but simultaneously require a shared decision-making interaction that involves the use of a validated tool. Accordingly, our objective was to evaluate the currently available decision aids for carotid stenosis.

Methods: We conducted a review of the literature for published work on decision aids for the treatment of carotid disease.

Results: Four publications met inclusion criteria. We found the format of the decision aid impacted patient comprehension and decision making, although patient characteristics also played a role in the therapeutic decisions made. Notably, none of the available decision aids included the widely adopted transcarotid artery revascularization as an option.

Conclusions: Further work is needed in the development of a widespread validated decision aid instrument for patients with carotid stenosis.

Keywords: Carotid artery stenosis; Carotid disease; Decision aid; Patient preferences; Shared decision-making.

PubMed Disclaimer

Conflict of interest statement

Disclosures None.

References

    1. Coverage and Analysis Group. Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting. Medicare Coverage Database; 2023.
    1. Stubenrouch FE, Peters LJ, de Mik SML, Klemm PL, Peppelenbosch AG, Schreurs SCWM, et al. Improving Shared Decision Making in Vascular Surgery: A Stepped Wedge Cluster Randomised Trial. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg 2022;64(1):73–81. Doi: 10.1016/j.ejvs.2022.04.016. - DOI - PubMed
    1. Ting HH, Brito JP, Montori VM. Shared Decision Making: Science and Action. Circ Cardiovasc Qual Outcomes 2014;7(2):323–7. Doi: 10.1161/CIRCOUTCOMES.113.000288. - DOI - PubMed
    1. Sarai M, Ray CE, Duszak R. An Ideal Opportunity for Interventional Radiologists to Advance Shared Decision Making. J Vasc Interv Radiol 2017;28(7):1022–4. Doi: 10.1016/j.jvir.2017.02.002. - DOI - PubMed
    1. Silver B, Zaman IF, Ashraf K, Majed Y, Norwood EM, Schuh LA, et al. A randomized trial of decision-making in asymptomatic carotid stenosis. Neurology 2012;78(5):315–21. Doi: 10.1212/WNL.0b013e31824528df. - DOI - PubMed