title: Duplex ultrasound surveillance after carotid artery endarterectomy.
abstract: After carotid endarterectomy (CEA), patients have been regularly followed up by duplex ultrasound imaging. However, the evidence for long-term follow-up is not clear, especially if the results from an early duplex scan are normal. This study assessed and systematically reviewed the evidence base for long-term surveillance after CEA and a normal early scan.
  
  
  
  Electronic databases were searched for studies assessing duplex surveillance after CEA in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome for this study was the incidence of restenosis after a normal early scan. The secondary outcome was the number of reinterventions after a normal early scan.
  
  
  
  The review included seven studies that reported 2317 procedures. Of those patients with a normal early scan, 2.8% (95% confidence interval, 0.7%-6%) developed a restenosis, and 0.4% (95% confidence interval, 0%-0.9%) underwent a reintervention for their restenosis during the follow-up period.
  
  
  
  This review confirms that routine postoperative duplex ultrasound surveillance after CEA is not necessary if the early duplex scan is normal.
authors.affiliation: Department of Renal Surgery, University Hospital Birmingham, Birmingham, United Kingdom; Department of Vascular Surgery, University Hospital Birmingham, Birmingham, United Kingdom. Electronic address: j.alshakarchi@nhs.net.
authors.forename: Julien
authors.initials: J
authors.lastname: Al Shakarchi
authors.affiliation: Department of Vascular Surgery, University Hospital Birmingham, Birmingham, United Kingdom.
authors.forename: Danielle
authors.initials: D
authors.lastname: Lowry
authors.affiliation: Department of Renal Surgery, University Hospital Birmingham, Birmingham, United Kingdom.
authors.forename: Jay
authors.initials: J
authors.lastname: Nath
authors.affiliation: Department of Renal Surgery, University Hospital Birmingham, Birmingham, United Kingdom.
authors.forename: Aurangzaib Z
authors.initials: AZ
authors.lastname: Khawaja
authors.affiliation: Department of Renal Surgery, University Hospital Birmingham, Birmingham, United Kingdom.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Inston
authors.affiliation: Department of Vascular Surgery, University Hospital Birmingham, Birmingham, United Kingdom.
authors.forename: Alok
authors.initials: A
authors.lastname: Tiwari
mesh_terms: D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D006801:Humans; D011237:Predictive Value of Tests; D012008:Recurrence; D019233:Retreatment; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D019564:Unnecessary Procedures