Vascular surgery outcomes are historically measured by mortality and morbidity. While some of these outcomes are directly important to patients (e.g., stroke after carotid revascularization), many of these technically focused metrics (e.g., primary patency) are not meaningful measures of treatment success from a patient’s perspective. To address this gap, patient reported outcomes (PROs) – defined by CMS as “any report of the status of a patient’s health condition or health behavior coming directly from the patient, without interpretation of the patient’s response by a clinician or anyone else” [1] – are increasingly used in conjunction with traditional outcomes to provide a more holistic understanding of treatment outcomes and disease impact.

Patient-reported outcome measures (PROMs) are classified as generic, disease-, or condition-specific depending on their structure and content. Generic PROMs measure across multifarious populations and disease states. Disease- and condition-specific PROMs measure the patient’s perspective on a particular disease and specific aspects of their health, respectively [2]. Many disease-specific PROMs are used in vascular surgery, particularly for peripheral arterial disease, thoracic outlet syndrome, and venous disease, yet PROMs specific to atherosclerotic carotid disease are not well described [3].

Carotid disease is particularly well-suited for the use of PROMs because of the existence of multiple treatment modalities, each with a unique set of tradeoffs: best medical therapy (BMT), trans-carotid arterial revascularization (TCAR), trans-femoral carotid artery stenting (TF-CAS), and carotid endarterectomy (CEA). Furthermore, there are significant controversies such as whether contemporary BMT is superior to any surgical intervention for asymptomatic disease [4]. At present, surgical technique is chosen based on physiological and anatomic risk with the incorporation of patient preference informally and only at the physician’s discretion. The use of PROMs holds the potential to improve the care of carotid disease by augmenting clinical decision by clarifying indications and expectations for patients regarding revascularization. For example, PROMs can supplement the decision to revascularize in asymptomatic patients, inform patients of expected quality of life (QoL) changes after carotid revascularization, and guide the surgical approach when revascularization is indicated.

In this narrative review, we aim to describe PROMs used to date in carotid revascularization studies and explore the effects of carotid revascularization on QoL, compare intervention specific effects on QoL, and discuss the influence of periprocedural complications. We conclude with a discussion about limitations in current PROM use.