TY - JOUR

T1 - Screening with doppler ultrasound for carotid artery stenosis in patients with stroke or transient ischaemic attack

AU - Kristensen, Tatiana

AU - Hovind, Peter

AU - Iversen, Helle K

AU - Andersen, Ulrik B

N1 - © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

PY - 2018

Y1 - 2018

N2 - INTRODUCTION: Carotid endarterectomy of symptomatic internal carotid artery stenosis in patients with stroke or transient ischaemic attack reduces the risk of recurrent stroke, particularly if performed within 2 weeks from the first event. We evaluated the efficiency of a screening programme based on Doppler ultrasound in patients hospitalized with stroke or transient ischaemic attack in the stroke centre at Rigshospitalet, Glostrup, Denmark, concerning timeliness of referral to the vascular surgeon and performance of carotid endarterectomy according to national recommendations.METHODS: Prospective study of a consecutive cohort of patients with transient ischaemic attack or stroke, referred for carotid Doppler ultrasound over a one-year period.RESULTS: We examined 1390 patients (1048 with stroke, 342 with transient ischaemic attack), 71% within 24 h and 93% within 4 days after admission. Carotid stenosis or occlusion was found in 171 patients (12·3%) and was hemisphere related in 78 patients (5·6%). Among these, 68 (87%) were referred to the vascular department, 94% within 4 days of admission. Carotid endarterectomy was performed in 16 patients, all within 14 days from admission, and was not declined in any patient due to procedural delay.CONCLUSIONS: In a major Danish stroke centre, the national recommended time limit of 4 days in patients with stroke or transient ischaemic attack for screening for carotid stenosis was met in almost all patients. No patients were excluded from surgery as a result of a time limit of 14 days from admission to surgery being exceeded. Of all patients screened, 1·2% underwent carotid endarterectomy.

AB - INTRODUCTION: Carotid endarterectomy of symptomatic internal carotid artery stenosis in patients with stroke or transient ischaemic attack reduces the risk of recurrent stroke, particularly if performed within 2 weeks from the first event. We evaluated the efficiency of a screening programme based on Doppler ultrasound in patients hospitalized with stroke or transient ischaemic attack in the stroke centre at Rigshospitalet, Glostrup, Denmark, concerning timeliness of referral to the vascular surgeon and performance of carotid endarterectomy according to national recommendations.METHODS: Prospective study of a consecutive cohort of patients with transient ischaemic attack or stroke, referred for carotid Doppler ultrasound over a one-year period.RESULTS: We examined 1390 patients (1048 with stroke, 342 with transient ischaemic attack), 71% within 24 h and 93% within 4 days after admission. Carotid stenosis or occlusion was found in 171 patients (12·3%) and was hemisphere related in 78 patients (5·6%). Among these, 68 (87%) were referred to the vascular department, 94% within 4 days of admission. Carotid endarterectomy was performed in 16 patients, all within 14 days from admission, and was not declined in any patient due to procedural delay.CONCLUSIONS: In a major Danish stroke centre, the national recommended time limit of 4 days in patients with stroke or transient ischaemic attack for screening for carotid stenosis was met in almost all patients. No patients were excluded from surgery as a result of a time limit of 14 days from admission to surgery being exceeded. Of all patients screened, 1·2% underwent carotid endarterectomy.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carotid Stenosis/complications

KW - Denmark

KW - Endarterectomy, Carotid

KW - Female

KW - Guideline Adherence

KW - Hospitalization

KW - Humans

KW - Ischemic Attack, Transient/diagnostic imaging

KW - Male

KW - Middle Aged

KW - Practice Guidelines as Topic

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Referral and Consultation

KW - Stroke/diagnostic imaging

KW - Time Factors

KW - Time-to-Treatment

KW - Ultrasonography, Doppler, Duplex/standards

U2 - 10.1111/cpf.12456

DO - 10.1111/cpf.12456

M3 - Journal article

C2 - 28782913

VL - 38

SP - 617

EP - 621

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

SN - 1475-0961

IS - 4

ER -