Carotid endarterectomy with normal findings from a completion study: Is there need for early duplex scan?

Carol Pross, Christine M. Shortsleeve, J. Dennis Baker, Jason K. Sicklick, Michael M. Farooq, Wesley S. Moore, William J. Quiñones-Baldrich, S. S. Ahn, Hugh A. Gelabert, Julie A. Freischlag

Research output: Contribution to journalArticle

Abstract

The objective of this study was to determine the value of early (<6 months) duplex scanning after carotid endarterectomy (CEA) with an intraoperative completion study with normal results. Attention was paid to restenosis rates and reoperation for recurrent stenosis within the first 6 months. Methods: A retrospective review was performed on 380 CEAs (338 patients) with intraoperative completion studies and duplex surveillance within the first 6 months. Results of completion studies, restenosis rates, and recurrent symptoms were evaluated for each operation. Studies were performed from 0 to 200 days postoperatively (median, 28). Results: Intraoperative completion studies included 333 angiograms, 26 duplex scans, and 21 angiograms with duplex scans. Of the 380 intraoperative completion studies, 28 (7.5%) had abnormal findings, including 14 abnormal internal carotid arteries (ICAs). Twenty-four procedures were revised, and the findings of all repeat completion studies were normal. Of the initial completion studies, in four cases, abnormalities (3 ICAs) were insignificant and did not warrant further intervention. Follow-up ICA duplex scans had normal results after 364 (95.8%) CEAs. There were 14 mild recurrent ICA stenoses and two moderate recurrent ICA stenoses; neither had abnormal findings from the completion study. There were no severe recurrent ICA stenoses. External carotid artery (ECA) recurrent stenosis included 7 mild, 15 moderate, and 9 severe restenoses. Conclusions: Only 0.5% of CEAs developed moderate restenosis. No procedures had severe recurrent stenosis on duplex scan within the first 6 months, and none required intervention. Duplex surveillance in the first 6 months is relatively unproductive, providing that there were normal results from an intraoperative completion study for each patient. Routine surveillance can be started at 1 year.

Original languageEnglish (US)
Pages (from-to)963-967
Number of pages5
JournalJournal of Vascular Surgery
Volume33
Issue number5
DOIs
StatePublished - May 2001
Externally publishedYes

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Carotid Endarterectomy
Carotid Stenosis
Internal Carotid Artery
Angiography
Pathologic Constriction
Reoperation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Pross, C., Shortsleeve, C. M., Baker, J. D., Sicklick, J. K., Farooq, M. M., Moore, W. S., ... Freischlag, J. A. (2001). Carotid endarterectomy with normal findings from a completion study: Is there need for early duplex scan? Journal of Vascular Surgery, 33(5), 963-967. https://doi.org/10.1067/mva.2001.115001

Carotid endarterectomy with normal findings from a completion study : Is there need for early duplex scan? / Pross, Carol; Shortsleeve, Christine M.; Baker, J. Dennis; Sicklick, Jason K.; Farooq, Michael M.; Moore, Wesley S.; Quiñones-Baldrich, William J.; Ahn, S. S.; Gelabert, Hugh A.; Freischlag, Julie A.

In: Journal of Vascular Surgery, Vol. 33, No. 5, 05.2001, p. 963-967.

Research output: Contribution to journalArticle

Pross, C, Shortsleeve, CM, Baker, JD, Sicklick, JK, Farooq, MM, Moore, WS, Quiñones-Baldrich, WJ, Ahn, SS, Gelabert, HA & Freischlag, JA 2001, 'Carotid endarterectomy with normal findings from a completion study: Is there need for early duplex scan?', Journal of Vascular Surgery, vol. 33, no. 5, pp. 963-967. https://doi.org/10.1067/mva.2001.115001
Pross, Carol ; Shortsleeve, Christine M. ; Baker, J. Dennis ; Sicklick, Jason K. ; Farooq, Michael M. ; Moore, Wesley S. ; Quiñones-Baldrich, William J. ; Ahn, S. S. ; Gelabert, Hugh A. ; Freischlag, Julie A. / Carotid endarterectomy with normal findings from a completion study : Is there need for early duplex scan?. In: Journal of Vascular Surgery. 2001 ; Vol. 33, No. 5. pp. 963-967.
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abstract = "The objective of this study was to determine the value of early (<6 months) duplex scanning after carotid endarterectomy (CEA) with an intraoperative completion study with normal results. Attention was paid to restenosis rates and reoperation for recurrent stenosis within the first 6 months. Methods: A retrospective review was performed on 380 CEAs (338 patients) with intraoperative completion studies and duplex surveillance within the first 6 months. Results of completion studies, restenosis rates, and recurrent symptoms were evaluated for each operation. Studies were performed from 0 to 200 days postoperatively (median, 28). Results: Intraoperative completion studies included 333 angiograms, 26 duplex scans, and 21 angiograms with duplex scans. Of the 380 intraoperative completion studies, 28 (7.5{\%}) had abnormal findings, including 14 abnormal internal carotid arteries (ICAs). Twenty-four procedures were revised, and the findings of all repeat completion studies were normal. Of the initial completion studies, in four cases, abnormalities (3 ICAs) were insignificant and did not warrant further intervention. Follow-up ICA duplex scans had normal results after 364 (95.8{\%}) CEAs. There were 14 mild recurrent ICA stenoses and two moderate recurrent ICA stenoses; neither had abnormal findings from the completion study. There were no severe recurrent ICA stenoses. External carotid artery (ECA) recurrent stenosis included 7 mild, 15 moderate, and 9 severe restenoses. Conclusions: Only 0.5{\%} of CEAs developed moderate restenosis. No procedures had severe recurrent stenosis on duplex scan within the first 6 months, and none required intervention. Duplex surveillance in the first 6 months is relatively unproductive, providing that there were normal results from an intraoperative completion study for each patient. Routine surveillance can be started at 1 year.",
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AU - Sicklick, Jason K.

AU - Farooq, Michael M.

AU - Moore, Wesley S.

AU - Quiñones-Baldrich, William J.

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AU - Gelabert, Hugh A.

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N2 - The objective of this study was to determine the value of early (<6 months) duplex scanning after carotid endarterectomy (CEA) with an intraoperative completion study with normal results. Attention was paid to restenosis rates and reoperation for recurrent stenosis within the first 6 months. Methods: A retrospective review was performed on 380 CEAs (338 patients) with intraoperative completion studies and duplex surveillance within the first 6 months. Results of completion studies, restenosis rates, and recurrent symptoms were evaluated for each operation. Studies were performed from 0 to 200 days postoperatively (median, 28). Results: Intraoperative completion studies included 333 angiograms, 26 duplex scans, and 21 angiograms with duplex scans. Of the 380 intraoperative completion studies, 28 (7.5%) had abnormal findings, including 14 abnormal internal carotid arteries (ICAs). Twenty-four procedures were revised, and the findings of all repeat completion studies were normal. Of the initial completion studies, in four cases, abnormalities (3 ICAs) were insignificant and did not warrant further intervention. Follow-up ICA duplex scans had normal results after 364 (95.8%) CEAs. There were 14 mild recurrent ICA stenoses and two moderate recurrent ICA stenoses; neither had abnormal findings from the completion study. There were no severe recurrent ICA stenoses. External carotid artery (ECA) recurrent stenosis included 7 mild, 15 moderate, and 9 severe restenoses. Conclusions: Only 0.5% of CEAs developed moderate restenosis. No procedures had severe recurrent stenosis on duplex scan within the first 6 months, and none required intervention. Duplex surveillance in the first 6 months is relatively unproductive, providing that there were normal results from an intraoperative completion study for each patient. Routine surveillance can be started at 1 year.

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