The American Vascular Association Screening Program: Rationale, Method, Guidelines, and Progress

Lavenson, George S.

doi:10.1177/154431670502900206

Cited by 4 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of CAD in seniors was determined in 2002-2003 by staff screening of 22,496 seniors in 75 institutions in the U.S. and Canada including those by the Society for Vascular Surgery (SVS), the Society for Vascular Ultrasound (SVU), the American Vascular Association (AVA), NYU, MAMC, and KDDH in Central California. The resulting incidence of CAD rounded off to a rather uniform 8% (20). The principal investigators of the study were author LG and Bonnie Johnson, the then Chief Vascular Technologist of the Vascular Laboratory at Stanford University.…”

Section: Resultsmentioning

confidence: 99%

“…These were sorted out for a later more lengthy full DUS, further evaluation, and appropriate management. The QCS is extremely accurate and had a sensitivity of 97% and specificity of 93% when evaluated at New York University (NYU) (20).…”

Section: Methodsmentioning

confidence: 99%

“…(I) USPSTF: the incidence of CAD in the general population is only 1%, making screening not of value or cost-effective. But strokes occur almost entirely in the senior population where the incidence of CAD is not 1% but rather 8% (20).…”

Section: Not Screeningmentioning

confidence: 99%

“…Most physicians will auscultate over the cervical carotid artery with a stethoscope as part of a senior's annual physical examination and will refer the patient with an audible bruit for a carotid DUS. But the sensitivity of an audible bruit is only 50% or less (20) and over half of those with significant ACS will not have an audible bruit. In the same time a QCS could be used with a sensitivity of 97% compared to listening for a bruit with a sensitivity of only 50%.…”

Section: Use Of a Cervical Bruit To Select For A Full Dusmentioning

confidence: 99%

See 3 more Smart Citations

The quick carotid scan for prevention of strokes due to carotid artery disease

Lavenson¹,

Andersen²

2021

Ann Transl Med

View full text Add to dashboard Cite

There are approximately 800,000 strokes in the United States (U.S.) annually. This number has remained the same for decades despite efforts at prevention. The Center for Disease Control (CDC) estimates that 80% of strokes could be prevented. A prime reason for failure of prevention is that the three immediate modifiable causes of strokes, carotid artery disease (CAD), atrial fibrillation (AFib), and hypertension (HTN) are asymptomatic in 80% of cases prior to the stroke. Strokes occur predominantly in seniors and the only possible means of reducing strokes on a large scale is to screen seniors for the asymptomatic disease so that it can be preemptively managed. We present a quick, accurate and cost-effective method of screening the senior population for asymptomatic carotid disease. The technique is a quick carotid scan (QCS). The QCS is a 1-minute long, image only, rapid, color flow ultrasound scan of the cervical carotid arteries that had a sensitivity of 97% when evaluated at New York University (NYU). Once identified by the QCS the approximately 8% of those screened found to have a positive QCS can then be referred for a full carotid duplex ultrasound (DUS). Those patients with a positive DUS can then be referred for further evaluation and appropriate stroke prevention management. The use of a full carotid DUS for screening widely for carotid disease is too time consuming and too costly.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Not Screeningmentioning

confidence: 99%

Section: Use Of a Cervical Bruit To Select For A Full Dusmentioning

confidence: 99%

See 2 more Smart Citations

The quick carotid scan for prevention of strokes due to carotid artery disease

Lavenson¹,

Andersen²

2021

Ann Transl Med

View full text Add to dashboard Cite

show abstract

“…Carotid ultrasound is generally performed on symptomatic patients who present with a possible CVA or a transient ischemic attack. Carotid ultrasound can also be used to screen asymptomatic patients [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Is B-mode ultrasound alone a sufficient screening tool for carotid stenosis? A pilot study

Bhandari

Socransky

2014

Crit Ultrasound J

View full text Add to dashboard Cite

BackgroundCarotid ultrasound is performed solely in hospital ultrasound departments or outpatient labs, using both B- and Doppler modes. We hypothesize that B-mode without Doppler can be used to classify patients as having carotid stenosis (CS) above or below 50%. Our objective is to determine the frequency with which a CS >50% is found using Doppler when no such stenosis was visible using B-mode.MethodsThis was a retrospective study of 100 patients referred to the stroke clinic and 100 patients referred for carotid endarterectomy (CEA). All patients had an elective carotid ultrasound done at Health Sciences North. The ultrasound reports were mixed together and blinded. Investigators determined if there was a CS of greater or less than 50% based on the carotid diagram. These results were compared to the degree of CS found on Doppler.ResultsIn the CEA group, there were 198 ultrasounds, with 153 showing a CS of >50%. Only one case of CS >50% was missed by B-mode. In the clinic group, 32 of 192 ultrasounds showed a CS of >50%. None were missed by B-mode. B-mode had a sensitivity and negative predictive value of 100% and a specificity of 65%.ConclusionThis study supports the theory that it may be possible to use B-mode ultrasound without Doppler to reliably determine if there is CS above or below 50%. Further research is required before carotid ultrasound using B-mode alone can be recommended.

show abstract

Noninvasive Vascular Testing—A 35‐Year Reflection

Lavenson

2005

World j. surg.

View full text Add to dashboard Cite

Noninvasive vascular testing has made a major contribution to the care of vascular surgery patients. This article a reflection on a 35-year corroborative association with Doctor Norman Rich, during which many of the advances in noninvasive vascular testing have been witnessed and effected. I served my vascular surgery fellowship under Doctor Rich in 1967-68 at Walter Reed Army Hospital. The only noninvasive vascular equipment then was a pencil probe Doppler. The value of the Doppler in the management of peripheral vascular disease that year and in determining limb viability in combat surgery in Vietnam the following year was established, and both experiences were published. Later, Doctor Rich established the annual Military Vascular Surgery Meeting and was appointed as the first Chair of the Department of Surgery at the Uniformed Services University for Health Sciences (USU). I entered private practice in Central California in 1976, and ultrasonic imaging was developed which allowed noninvasive examination of the carotid arteries. I then developed a protocol to screen for the three silent, immediate causes of stroke, employing a "a quick carotid scan" for carotid artery disease, a lead II rhythm strip for atrial fibrillation, and blood pressure determination for hypertension so that these common causes of strokes could be recognized and treated, and potentially prevent the majority of strokes. My association with USU, Doctor Rich, and others involved proved instrumental in initiating implementation of stroke prevention screening. The structure established at USU provides a means of establishing the protocol nationally. Noninvasive vascular testing is an addition to Medical Science that has led to significant improvements in individual patient care and that has the potential of allowing a major reduction in death and disability from stroke and other vascular diseases. Throughout a 35-year collaborative association with Doctor Norman M. Rich, I have witnessed and developed many of these advances. These contributions to noninvasive vascular testing reflect the value of our collaboration.

show abstract

The American Vascular Association Screening Program: Rationale, Method, Guidelines, and Progress

Cited by 4 publications

References 12 publications

The quick carotid scan for prevention of strokes due to carotid artery disease

The quick carotid scan for prevention of strokes due to carotid artery disease

Is B-mode ultrasound alone a sufficient screening tool for carotid stenosis? A pilot study

Noninvasive Vascular Testing—A 35‐Year Reflection

Contact Info

Product

Resources

About