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To assess the cost-effectiveness of four diagnostic strategies for the preoperative evaluation of symptomatic patients who are potential candidates for carotid endarterectomy(ie,70%to 99%stenosis):(1)duplex sonography(DS),(2)magnetic resonance angiography(MRA),(3)contrast angiography(CA),and(4)the combination of DS and MRA supplemented by CA for disparate results.Our results suggest that for the preoperative detection of a 70%to 99%carotid stenosis,the combination of DS and MRA,supplemented by CA for disparate results,is associated with the lowest long-term morbidity and mortality and has a favorable cost-effectiveness ratio.The combination of tests,or DS alone when MRA is not available,could potentially replace the current practice of using CA alone in the preoperative evaluation of patients with symptomatic carotid stenosis. |
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carotid angiogram carotid artery carotid artery disease carotid artery disease,noninvasive evaluation of carotid artery stenosis cerebrovascular accident cerebrovascular accident,work up for cerebrovascular disease,noninvasive evaluation of cost effectiveness doppler duplex ultrasound endarterectomy,carotid MRI MRI,abnormal MRI,angiography MRI,cerebrovascular disease neurologic evaluation ultrasonography ultrasonography,carotid artery
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