Screening test for carotid disease.
Because cardiovascular disease is the leading cause of death in the United States, the identification of a screening test to reduce the risk of stroke has been a long-term goal of those interested in public health. The recent European and North American randomized carotid endarterectomy trials have demonstrated that both symptomatic and asymptomatic patients with internal carotid artery stenosis may experience a reduction of stroke risk when treated with endarterectomy. Thus the detection of occult carotid stenosis has been proposed as a stroke-reducing method. US has been studied both as a solitary screening method and in conjunction with hypertension and cardiac arrhythmia screening. This article reviews the methods proposed for US carotid artery screening, the reported accuracy of these methods, and issues of cost- and clinical effectiveness.
Bluth
Edward I
EI
Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA 70124, USA. ebluth@ochsner.org
D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008403:Mass Screening; D020521:Stroke / Q000517:prevention & control; D018608:Ultrasonography, Doppler; D014481:United States