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The clinical value of duplex surveillance following internal carotid artery reconstruction
H Lacroix1, A Nevelsteen, G Beyens
1Department of Vascular Surgery, University Hospital Gasthuisberg, Leuven, Belgium.
Background:
The purpose of this retrospective analysis was to evaluate the benefit of a yearly duplex ultrasonography of both the reconstructed and the contralateral internal carotid artery (ICA).
Methods:
From 1985 to 1994, 1210 unilateral, primary ICA reconstructions were performed. Although these patients received yearly invitations, duplex follow-up was not available in 114 patients (9%).
Results:
At 5 years a stenosis of 50% or more was found in 9% and at 10 years in 14% of patients. During the follow-up period 20 patients developed a stenosis of 80-99%. Ten patients had a redo-procedure. The others remained asymptomatic, even though one patient developed an occlusion. A stroke occurred in 96 patients. 58 of these had no significant stenoses. 57% of all patients had no significant contralateral lesion at the time of the first procedure. In only 4% of these a contralateral CAE was performed during the follow-up.
Conclusions:
In view of the above data, we would conclude that the clinical benefit of duplex surveillance is doubtful.