The positive effect of accurate noninvasive studies in decreasing the number of normal radiographic studies.
We examined the charts of all patients who had aortograms, venograms, and carotid arteriograms for a five-year period, beginning two years prior to the opening of our vascular lab, to determine the effect on these studies. The indications for radiologic studies, the results, and the therapeutic regimen instituted, if any, were analyzed for each patient. We found a negligible effect on the number of aortograms and hypothesize that this is due to the fact that segmental pressures rarely pick up asymptomatic patients. The total number of cerebral arteriograms was not affected; however, the percentage of positive studies for transient ischemic attacks showing severe extracranial carotid disease increased significantly (41% to 74%). We hypothesize that the minimal effect seen on the number of carotid arteriograms was due to a trade off, i.e., the number of patients not having an arteriogram due to a normal noninvasive exam was offset by those minimally symptomatic patients picked up by noninvasive exams to have high grade disease. The total number of venograms decreased significantly and there was a significant increase in the percentage of studies that tested positive for deep venous thrombosis (33% to 46%). The proper use of the vascular lab can significantly reduce the number of normal studies performed in radiology.
Department of Surgery, Community Hospital of Roanoke Valley, Virginia.
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Hill
D000792:Angiography; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging; D019411:Clinical Laboratory Techniques; D006801:Humans; D010690:Phlebography; D014652:Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging