Carotid Stenting October 18, 2000 Mary Ellen Foltz Medical Policy Pennsylvania Blue Shield Camp Hill, PA 17089 Dear Ms. Foltz: In reference to your previous correspondence of 9/5/00 regarding carotid stenting, enclosed is a brief position statement written by Drs. Tan and Wholey. It should be noted that National Chapter of the American College of Cardiology currently does not have a formal position statement on carotid stenting. However, Dr. Wholey's group from Shadyside Hospital in Pittsburgh has probably one of the largest patient populations who have undergone carotid stenting on an investigational basis, and Dr. Wholey is an international expert in this field. I believe his comments accurately reflect the field of cerebral vascular disease, the role of surgical therapy (i.e., carotid endarterectomy), and the expanding indications for percutaneous therapy (i.e., carotid stenting). Drs. Tan and Wholey point out that randomized clinical trials involving carotid stenting are currently underway. I hope this information is of some help to you. Please let me know if I can provide you with any additional information. Sincerely, James P. MacKrell, M.D., FACC District Councilor cc: A. Gradman, M.D. J. Kitchen, M.D. J. Cacchione, M.D. M. Elias