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Imaging of Carotid Artery Stenosis:Clinical Efficacy and Cost-effectiveness
AJNR 16:1875-1883, Vanninen,R.,et al, 1995
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Article Abstract
Ultrasound before angiography is a more effective and considerably cheaper than performing angiography in all patients presenting with transient ischemic attacks($25 216 versus$48 708 imaging costs per one prevented stroke).When the more costly MR angiography was used to select patients for angiography,the slightly higher diagnostic accuracy did not result in a greater number of prevented strokes.As the only preoperative scrutiny, the combination of ultrasound and MR angiography would have resulted in a greater number of prevented strokes than invasive angiography but at the expense of unnecessary surgery(6.6%of all surgeries).Ultrasound followed by confirmatory angiography is a cost effective way to image patients suspected of carotid artery stenosis.MR angiography may become cost effective and lead to a better final patient outcome only when it can reliably replace invasive angiography as the preoperative examination.
 
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carotid angiogram
carotid artery
carotid artery disease
carotid artery disease,noninvasive evaluation of
carotid artery stenosis
cerebrovascular disease,noninvasive evaluation of
cost effectiveness
doppler
endarterectomy,carotid
MRI,angiography
transient ischemic attack
ultrasonography
ultrasonography,carotid artery

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