Value of a Carotid Duplex Surveillance Program for Stroke Prevention

Vascular Laboratory and Imaging


The Value of a Carotid Duplex Surveillance Program for Stroke Prevention


Cull DL, Cole T, Miller B, et al (Greenville Hosp System-Univ Med Ctr, SC; Univ of South Carolina School of Medicine-Greenville Campus) Ann Vasc Surg 25:887–894, 2011§



G.L. Moneta, MD



Evidence Ranking


• A



Expert Rating


• 1



Abstract



Background


Although duplex ultrasonography (DU) can readily identify progression of carotid stenosis, controversy regarding the natural history of asymptomatic carotid stenosis as well as the need and appropriate interval for carotid DU surveillance still exists. Furthermore, consensus has not yet been made in the surgical literature regarding the usefulness, cost-effectiveness, or timing of DU surveillance after carotid endarterectomy (CEA). The purpose of this study was to determine how often DU surveillance for asymptomatic carotid disease or postintervention stenosis resulted in any change in the patient’s clinical management, how many strokes were prevented by DU surveillance, and the cost of such a DU surveillance program per stroke prevented.



Methods


We reviewed a 9-year vascular surgical database to identify all patients enrolled in a carotid DU surveillance program for asymptomatic carotid stenosis or following CEA between January 1, 2000, and December 31, 2008. The number of duplex scans and CEAs performed in those patients through March 2010 was also determined. The results of the Asymptomatic Carotid Atherosclerosis Study were then used to estimate the number of strokes prevented by CEA in the study population. Reimbursement data were assessed to calculate the average cost of each DU and the cost of the DU surveillance program for each stroke prevented.

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Apr 1, 2017 | Posted by in CARDIOLOGY | Comments Off on Value of a Carotid Duplex Surveillance Program for Stroke Prevention

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