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
...Diagnosis...
...Extracr...
...fter carotid endarterectomy (CEA) or carotid arte...
...dergoing CAS with diabetes, aggressive patterns...
...SVS recommends that DUS after CAS inc...
Figure 1. Morphologic Patterns of ISR Bas...
Table 1. Optimal Velocity Threshold Criteria for...
...Thoracic and Abdom...
...recommends contrast-enhanced CT scanning at 1...
...ecommends contrast-enhanced CT scanning at...
...ecommends contrast-enhanced CT scanning at 1...
...ds CT scanning with or without contrast enha...
...ds contrast-enhanced CT scanning at 1 month a...
...SVS recommends DUS at 12-month interva...
...he SVS recommends DUS and non-contrast...
...SVS recommends total aortic imaging with...
...Mesenteric...
...no prospective reports documenting the eff...
...suggests contrast imaging for pati...
...Renal Art...
...here are no prospective reports document...
...sts contrast-enhanced imaging for loss of renal p...
...Open Lower Ext...
...ends clinical examination and ABI, with or...
...on the high prevalence of abnormal...
...er prosthetic infrainguinal bypass grafts, t...
...e 2. DUS Velocity and ABI Threshold Crit...
...Endovascular Low...
...commends clinical examination, ABI,...
...S suggests clinical examination, ABI, and DUS...
...ests clinical examination, ABI, and...