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Medical cost savings through stroke prevention from 100 consecutive new carotid duplex scans
1Department of Surgery, Visalia Community Hospital, CA 93277, USA.
Insights
Duplex ultrasound for carotid artery stenosis detection is cost-effective. Identifying significant lesions and guiding treatment like carotid endarterectomy saves substantial medical costs by preventing costly strokes.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Health Economics
Background:
- Carotid endarterectomy for significant lesions reduces stroke risk and associated medical costs.
- Duplex ultrasound is the primary method for detecting carotid artery lesions.
- The cost-effectiveness of duplex ultrasound for carotid lesion management was previously unknown.
Purpose of the Study:
- To evaluate the cost-effectiveness of duplex ultrasound in managing patients with carotid artery stenosis.
- To determine the economic impact of using duplex ultrasound to identify patients needing intervention.
Main Methods:
- Review of findings and management for 100 consecutive patients referred for carotid duplex ultrasound.
- Analysis of patient management based on stenosis severity (<70% vs. >70%).
- Estimation of stroke incidence and associated costs in untreated patients versus intervention costs.
Main Results:
- 27 patients with >70% stenosis underwent carotid endarterectomy; 73 with <70% stenosis were managed non-operatively.
- An estimated 6.5 strokes were averted within 18 months due to timely intervention.
- The cost of preventing these strokes was $300,494, compared to potential stroke costs of $958,838.
Conclusions:
- Duplex ultrasound examination for carotid artery stenosis is a cost-effective diagnostic tool.
- Early detection and appropriate management guided by duplex ultrasound lead to significant healthcare cost savings.
- This imaging modality plays a crucial role in optimizing patient outcomes and resource allocation in cerebrovascular disease management.
Abstract:
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.