SynthesisAnnals of surgery2019
High Operator and Hospital Volume Are Associated With a Decreased Risk of Death and Stroke After Carotid Revascularization: A Systematic Review and Meta-analysis.
Synthesis in Annals of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Temporal trends in short- and long-term outcomes after carotid interventions for symptomatic or asymptomatic stenosis: a systematic review and meta-analysis.European stroke journal · 2026Pooled it
- External Validation of Risk Prediction Models to Improve Selection of Patients for Carotid Endarterectomy.Stroke · 2022Pooled it
- Diagnosis, Treatment and Follow-up in Extracranial Carotid Stenosis.Deutsches Arzteblatt international · 2020Pooled it
- Association of cerebrovascular center volume with patient outcomes.Neurosurgical review · 2026Review
- William M. Feinberg Lecture: Asymptomatic Carotid Stenosis: Current and Future Considerations.Stroke · 2024Review
- Association of Centre Quality Certification with Characteristics of Patients, Management, and Outcomes Following Carotid Endarterectomy or Carotid Artery Stenting.Journal of clinical medicine · 2024Article
- Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus.Neurocritical care · 2023Article
- Carotid endarterectomy with concomitant distal endovascular intervention is associated with increased rates of stroke and death.Journal of vascular surgery · 2021Article
- The less invasive paradox, why carotid artery stenting is not suitable for the high-risk patient.Annals of translational medicine · 2020Review
- Perioperative Stroke.Current neurology and neuroscience reports · 2020Review
- The Role of Carotid Stump Pressure in Carotid Endarterectomy: A Systematic Review and Meta-Analysis.Annals of vascular diseases · 2020Article
- Management of De Novo Carotid Stenosis and Postintervention Restenosis-Carotid Endarterectomy Versus Carotid Artery Stenting-a Review of Literature.Translational stroke research · 2019Review
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo examine the association between operator or hospital volume and procedural outcomes of carotid revascularization.
backgroundOperator and hospital volume have been proposed as determinants of outcome after carotid endarterectomy (CEA) or carotid artery stenting (CAS). The magnitude and clinical relevance of this relationship are debated.
methodsWe systematically searched PubMed and EMBASE until August 21, 2017. The primary outcome was procedural (30 days, in-hospital, or perioperative) death or stroke. Obtained or estimated risk estimates were pooled with a generic inverse variance random-effects model.
resultsWe included 87 studies. A decreased risk of death or stroke following CEA was found for high compared to low operator volume with a pooled adjusted odds ratio (OR) of 0.50 (95% confidence interval [CI] 0.28-0.87; 3 cohorts), and a pooled unadjusted relative risk (RR) of 0.59 (95% CI 0.42-0.83; 9 cohorts); for high compared to low hospital volume with a pooled adjusted OR of 0.62 (95% CI 0.42-0.90; 5 cohorts), and a pooled unadjusted RR of 0.68 (95% CI 0.51-0.92; 9 cohorts). A decreased risk of death or stroke after CAS was found for high compared to low operator volume with an adjusted OR of 0.43 (95% CI 0.20-0.95; 1 cohort), and an unadjusted RR of 0.50 (95% CI 0.32-0.79; 1 cohort); for high compared to low hospital volume with an adjusted OR of 0.46 (95% CI 0.26-0.80; 1 cohort), and no significant decreased risk in a pooled unadjusted RR of 0.72 (95% CI 0.49-1.06; 2 cohorts).
conclusionsWe found a decreased risk of procedural death and stroke after CEA and CAS for high operator and high hospital volume, indicating that aiming for a high volume may help to reduce procedural complications. REGISTRATION: This systematic review has been registered in the international prospective registry of systematic reviews (PROSPERO): CRD42017051491.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.