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• W2023257553 abstract "<h3>Objective:</h3> To compare carotid endarterectomy (CEA) based solely on Duplex ultrasonography (DU) with CEA based on DU and arteriography. <h3>Design and Setting:</h3> Retrospective case series analysis in a regional tertiary care center. <h3>Patients:</h3> Consecutive sample of 194 patients undergoing 218 CEAs from January 1, 1993, through June 30, 1995, with either preoperative DU plus arteriography (165 CEAs) or DU only (53 CEAs). <h3>Main Outcome Measures:</h3> Concordance of the 2 diagnostic imaging techniques and influence of these on the conduct of surgery, surgical outcome, and resource cost. <h3>Results:</h3> There was agreement (κ=0.85) between DU and arteriography in the detection of a carotid occlusion or a stenosis greater than 45%. Arteriography demonstrated 26 aortic arch branch lesions (15.8%), 22 intracranial abnormalities (13.3%), and 6 type C ulcers (3.6%), in addition to 1 nonoccluded internal carotid artery (ICA) (0.61%) and 1 contralateral severe ICA stenosis (0.61%) inaccurately estimated by Duplex. These findings prompted 3 changes (1.8%) in surgical therapy, including 2 decisions in favor of CEA and 1 subclavian-carotid bypass added to CEA. There was no difference in the stroke and death rate for CEA based solely on DU compared with CEA based on DU and arteriography (<i>P</i>=.43). The mean total hospital cost was $5534 for DU only CEA vs $7608 for DU plus arteriogram CEA (mean difference=$2074,<i>P</i><.01). <h3>Conclusions:</h3> The addition of carotid arteriography to a diagnostic Duplex ultrasound study that already suggested the need for CEA did not change the operative plan in 98% (162/165) of the cases. Carotid endarterectomy based solely on DU is appropriate and cost-effective. Arch Surg. 1997;132:268-271" @default.
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• W2023257553 date "1997-03-01" @default.
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• W2023257553 title "Cost-effective Evaluation and Treatment for Carotid Disease" @default.
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• W2023257553 doi "https://doi.org/10.1001/archsurg.1997.01430270054011" @default.
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