Underutilization of Routine Ultrasound Surveillance after Endovascular Aortic Aneurysm Repair

Annals of Vascular Surgery
Matthew W MellLaurence C Baker

Abstract

Since 2009, the Society for Vascular Surgery has advocated annual surveillance imaging with ultrasound (US) after the first postoperative year for uncomplicated endovascular aneurysm repairs (EVARs). We sought to describe diffusion of US into long-term routine surveillance and to estimate potential cost savings among Medicare beneficiaries after EVAR. Using Medicare claims data, we identified patients receiving EVAR from 2002 to 2010 and included only those who did not subsequently have reinterventions, late aneurysm-related complications, or death. We collected all relevant postoperative imaging (computed tomography [CT] and US) through 2011. Patients with follow-up less than 1 year were excluded. We estimated cost savings with increased use of US after the first postoperative year. The cohort comprised 24,615 patients with a mean follow-up of 3.9 ± 2.3 years. Mean number of images decreased from 2.23 in the first postoperative year to 0.31 in the 10th year. Utilization of US at the first postoperative year remained low but increased from 15.2% in 2003 to 28.8% in 2011 (P < 0.001). By the 10th postoperative year, the proportion of patients receiving US increased from 8.2% to 37.8%, while use of CT only remained high but decrea...Continue Reading

Citations

Sep 20, 2017·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Zhonghua Sun, Curtise K C Ng
Nov 19, 2017·Current Vascular Pharmacology·Djodje RadakEsma R Isenovic
Mar 3, 2020·Journal of Internal Medicine·L de GuerreM Schermerhorn
Apr 27, 2021·Journal of Biomechanics·Asaf RabinRana O Afifi
May 5, 2018·Journal of Vascular Surgery Cases and Innovative Techniques·Brian M LeoceThomas R Bernik
Jul 21, 2021·International Angiology : a Journal of the International Union of Angiology·Bharti SinghNuno V Dias

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