DRAFT

BORGESS MEDICAL CENTER

Kalamazoo, Michigan

CRITERIA TO PERFORM CAROTID STENT SUPPORT
ANGIOPLASTY (CSSA)

The following criteria for education, training, and experience must be met in order for a request for privileges to be considered complete; and for a specific request for clinical privileges to be granted.

I. EDUCATION REQUIREMENT:

A. M.D. or D.O.

 

II. TRAINING REQUIREMENT:

 

A. Completion of an accredited Cardiovascular Disease Fellowship or Interventional Radiology fellowship and/or

B. Completion of a Fellowship and/or residency in vascular surgery and/or neurosurgery.

 

III. EXPERIENCE REQUIREMENT:

 

A. Interventional Cardiovascular Disease Training

Successful completion of a dedicated interventional cardiovascular disease fellowship with competency in the performance of coronary balloon angioplasty and coronary stent insertion as attested by the program director; or successful completion of >100 coronary stent procedures as primary operator. The individual must have privileges at Borgess Medical Center for coronary stent insertion.

PLUS

Experience with revascularization in peripheral arteries (mini-mum 10 cases) and certification (from Schneider) to perform peripheral vascular Wallstent implantation.

 

 

PLUS

Experience and credentialing for the placement of temporary transvenous pacemaker (required for bradycardia risk with carotid stenting).

OR

B. Training, experience and privileges (at Borgess Medical Center) to perform peripheral vascular intervention as attested by the performance of at least 75 peripheral vascular interventions with angioplasty and a minimum of 50 peripheral vascular procedures involving the use of stenting.

PLUS

Training and certification for peripheral vascular Wallstent implantation.

PLUS

Experience and priveledges for the placement of temporary transvenous pacemaker (required for bradycardia risk with carotid stenting). May work in collaboration with another physician with pacemaker priveledges.

 

Note:

Individuals in category both A or B must also attend at least one course where there is didactic material and live case demonstrations of carotid stent implantation and must observe and/or participate in catheterization laboratory in the performance of 2 or more carotid stent insertions with a proctor prior to their first procedure at Borgess Medical Center.

IV. MISCELLANEOUS

A. Applicants for these privileges must agree to consistently comply with adopted protocols regarding patient selection for carotid stent insertion and the submission of data for institutional use. In addition, until such time carotid supported angioplasty an accepted mode of carotid revascularization (as denoted by the availability of an FDA approved device for this specific indication), all physicians wishing this privilege must be either the principal investigator or a co-investigator in an IRB approved investigational protocol.