Medical cost savings through stroke prevention from 100 consecutive new carotid duplex scans

Recent studies have shown that carotid endarterectomy for significant lesions lowers the risk of stroke and also reduces medical costs by averting the high costs of strokes. However, there has been no information on the cost effect of duplex ultrasound examination which has evolved as the prime means of discovering these carotid lesions. This study reviewed the findings and management of 100 consecutive new patients referred for duplex ultrasound management of the carotid arteries and the cost effects resulting. Seventy-three patients with < 70% stenosis were managed non-operatively; the remaining 27 with 33 lesions producing > 70% stenosis were treated by carotid endarterectomy. It was estimated that 6.5 patients would have had a stroke within 18 months if not operated on. While the medical costs of these strokes would have been $958,838, the cost of avoiding them was $300,494; the result was a significant medical costs saving of $658,344.