Safety and efficacy of carotid arteriography in vascular surgery practice

Peter A. Schneider, Michael B. Silva, W. Todd Bohannon, Karthikeshwar Kasirajan, Michael T. Caps, Nicolas Nelken, Dixon Santana

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Objective: Carotid arteriography (CA) is an important method of assessing carotid artery occlusive disease and is the best method of planning for carotid angioplasty and stent placement (CAS). This study compared the results of CA performed by vascular surgeons in a contemporary series against widely recognized interdisciplinary quality standards for this procedure. Although many vascular surgeons perform CA, there is a paucity of data about its safety, efficacy, and compliance with quality standards in vascular practice. The importance of quality CA will likely increase as CAS emerges to assume a broader clinical role. Method: Carotid arteriograms performed by seven vascular surgeons at three institutions from September 2000 to May 2004 were reviewed. These results were compared with quality standards for the performance of CA. Results: Five hundred three carotid arteriograms were performed over 45 months. Indications for the procedure were extracranial cerebrovascular disease (86%), trauma (5%), and other conditions (9%). Indications for the procedure were appropriate in 100% of patients (as determined by guidelines document) and exceeded the recommended standard of appropriate indications in 99%. All procedures successfully provided the information required, exceeding the threshold of 98% for procedural success. Reversible neurologic deficits occurred in 0.6% (two transient ischemic attacks and one stroke) compared with the threshold of 2.5%. A permanent neurologic deficit occurred in 0.2% (1 patient) compared with the published guideline of 1% after carotid arteriography. Major non-neurologic complications occurred in 1.2% (6 patients), less than the standard of 2.0%. Conclusions: The safety and efficacy of a contemporary series of CA performed in vascular surgery practice compared favorably with recognized interdisciplinary quality standards for this procedure. Ensuring safe and effective CA is likely to support the successful growth of CAS as a treatment option.

Original languageEnglish (US)
Pages (from-to)238-245
Number of pages8
JournalJournal of vascular surgery
Volume41
Issue number2
DOIs
StatePublished - Feb 2005
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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    Schneider, P. A., Silva, M. B., Bohannon, W. T., Kasirajan, K., Caps, M. T., Nelken, N., & Santana, D. (2005). Safety and efficacy of carotid arteriography in vascular surgery practice. Journal of vascular surgery, 41(2), 238-245. https://doi.org/10.1016/j.jvs.2004.11.024