Carotid angioplasty with associated stenting and embolic protection may be considered medically necessary in individuals with:
50% to 99% stenosis (North American Symptomatic Carotid Endarterectomy Trial [NASCET] measurement); AND
symptoms of focal cerebral ischemia (transient ischemic attack or monocular blindness) in the previous 120 days, symptom duration less than 24 hours, or nondisabling stroke; AND
anatomic contraindication for carotid endarterectomy (eg, prior radiotherapy or neck surgery, lesions surgically inaccessible, spinal immobility, or tracheostomy).
Carotid angioplasty with associated stenting and embolic protection is considered investigational for all other indications, including but not limited to, individuals with carotid stenosis who are suitable candidates for carotid endarterectomy and patients with carotid artery dissection.
Carotid angioplasty without associated stenting and embolic protection is considered investigational for all indications, including but not limited to, individuals with carotid stenosis who are suitable candidates for carotid endarterectomy and patients with carotid artery dissection.
