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Published on: January 15, 2017
'Fast track' carotid duplex scanning in a district general hospital
S Kumar1, I S Osman, C J Woollard
1Department of Surgery, Ipswich Hospital NHS Trust, UK.
Unlabelled:
'Fast track' carotid scanning is designed to rapidly identify patients with significant symptomatic carotid stenosis and, thereby, allow prompt surgery. We review the outcome of patients referred to our open-access scanning service over 3 years and 6 months. A total of 807 cases (62% males and 38% females with a mean age of 64 years) were referred. The main presenting symptoms were TIA in 69%, amaurosis fugax in 11% and minor CVA in 8.3%. The mean time between referral and scan was 17 days. In 80% of the cases, the scan showed no significant disease and the patients were not seen in the clinic. Significant abnormality (stenosis > 70% or occlusion) was found in 20% of the patients. Of the total, 12% were reviewed in the out-patient clinic following which no action was taken, 2% had angiography but no surgery, while 5% had angiography and surgery. 1% were lost to follow-up. The mean delay from scan to operation was 36 days.
Conclusion:
Fast track scanning has led to early detection of surgically relevant carotid lesions and avoidance of delay in surgical intervention. It is an efficient and cost-effective practice.
