Follow-Up After Vascular Surgery Arterial Procedures
Key Points
Key Points
It is generally accepted that achieving optimal outcomes from open surgical and endovascular procedures depends on periodic follow-up and appropriate reintervention.
The options for follow-up range from a simple vascular history and physical examination (often including ankle-brachial index [ABI] measurement for procedures involving the lower extremity arteries) to sophisticated imaging methods such as computed tomography (CT) or magnetic resonance (MR) angiography and more invasive catheter angiography.
Noninvasive vascular laboratory tests, particularly duplex ultrasound (DUS), are ideally suited for this purpose because they are safe and relatively low in cost, and they provide objective anatomic and physiologic information that can be used to assess the durability of a vascular intervention over time.
The goal of routine surveillance is to identify intervention sites that are at risk for failure, even in the absence of signs or symptoms. However, this approach is justified only if the consequences of failure are severe and early reintervention can improve the outcome.
Additional requirements are the availability of accurate testing methods with clinically relevant threshold criteria and appropriate follow-up or testing intervals.
Diagnosis
...Diag...
...Extracranial Carotid Art...
...fter carotid endarterectomy (CEA) or carotid art...
...nts undergoing CAS with diabetes, aggressive patte...
The SVS recommends that DUS after CAS inclu...
...gure 1. Morphologic Patterns of ISR Bas...
...imal Velocity Threshold Criteria for Varying Sev...
...Thoracic and Abdominal...
...ecommends contrast-enhanced CT scanning...
...he SVS recommends contrast-enhanced...
...commends contrast-enhanced CT scanning at 1 month...
...nds CT scanning with or without contrast enh...
...SVS recommends contrast-enhanced CT scanning at...
...ds DUS at 12-month intervals as alternative i...
The SVS recommends DUS and non-contras...
...nds total aortic imaging with non-contrast-...
...Mesenteric Arteries...
...o prospective reports documenting the effic...
...e SVS suggests contrast imaging for patients...
...Renal Arterie...
...spective reports documenting the effica...
...SVS suggests contrast-enhanced imaging for...
...Open Lower Extremity Ar...
The SVS recommends clinical examination and ABI...
...he high prevalence of abnormalities detected...
...thetic infrainguinal bypass grafts, the SVS reco...
...able 2. DUS Velocity and ABI Threshold...
The SVS recommends clinical examinati...
The SVS suggests clinical examination...
...gests clinical examination, ABI, an...