Cost of routine screening for carotid and lower extremity occlusive disease in patients with abdominal aortic aneurysms

Journal of Vascular Surgery
David A AxelrodGilbert R Upchurch

Abstract

The burden of clinically relevant noncoronary atherosclerotic occlusive disease in patients with abdominal aortic aneurysms (AAAs) is poorly defined. Furthermore, the cost-effectiveness of routine versus selective preoperative noninvasive examination of the carotid and lower extremity arterial beds has not been established in patients who undergo elective AAA repair. Diagnostic vascular laboratory study results were reviewed in 206 patients who underwent evaluation before AAA repair from 1994 to 1998. The patients underwent routine preoperative carotid duplex scan examinations and lower extremity Doppler scan arterial studies with ankle-brachial index (ABI) determinations. The medical records were reviewed for the identification of clinical evidence consistent with cerebrovascular or lower extremity arterial occlusive disease. The costs of routine screening and selective screening were determined with Medicare reimbursement schedules. The prevalence rate of advanced (80% to 100%) carotid artery stenosis (CAS) was 3.4%, and 18% of the patients had CAS between 60% and 100%. Advanced peripheral vascular occlusive disease (PVOD; ABI, <0.3) was found in 3% of the patients, and 12% of the patients had an ABI of less than 0.6. Most pa...Continue Reading

References

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Citations

Jul 11, 2009·The British Journal of Surgery·D J ParryD J A Scott
Mar 1, 2006·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Sallie UrfferEric Wilson
Jan 14, 2004·Journal of Vascular Surgery·Caron B RockmanThomas S Riles
Jan 14, 2004·Journal of Vascular Surgery·David A AxelrodPeter K Henke
Oct 16, 2003·Journal of Vascular Surgery·Glenn R JacobowitzThomas S Riles
Sep 6, 2011·Journal of Vascular Surgery·John J RicottaUNKNOWN Society for Vascular Surgery

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