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A Review of Carotid Artery Screening: The Benefits and Risks

admin - September 12, 2013



carotid artery screening review

To treat a condition, it first needs to be detected.

That’s the message in a recent Wall Street Journal article titled “A Common Test to Screen for Stroke Risk is Under Review”. The article, written by Laura Landro, takes a look at the pros and cons of carotid artery ultrasound, like the one provided by Life Line Screening.

The 2007 recommendation from the U.S. Preventive Services Task Force against screening patients without symptoms of disease has gained much attention in recent years. However, this article notes that since its establishment five years ago, stating that the evidence has become quite outdated. Because of this, the task force is now reviewing that recommendation.

 

A Living Example

Ken Goins, a Life Line Screening participant, is featured in the article. After participating in a carotid artery screening that revealed an 85 percent blockage in his left carotid artery, Goins underwent a carotid endarterectomy. This surgical procedure removed the plaque in his artery and restored normal blood flow to lower risk of stroke.

Goins, now 70, is a firm believer that the carotid artery screening saved his life.

“This is the best birthday present anyone could receive, which is their life,” Goins told his wife after his life-saving treatment.

USPSTF representative Dr. LeFevre points out in the article that the ultrasound testing for carotid artery disease itself is not dangerous. Rather, the concern lies in the follow-up process – a much larger, systemic problem of appropriate medical management.

For example, one of the primary concerns pertaining to carotid artery screenings is on the events following the screening that can “do more harm than good.” This includes follow-up testing involving an angiogram to confirm the findings of the screening. The angiogram uses a dye that can actually put patients at higher risk of stroke. Angiograms with large amounts of dye, however, are no longer commonly performed.

Furthermore, controversy has surrounded carotid artery screening because of the risks associated with surgery as a form of treatment. The surgery itself has been linked to a 3 percent rate of stroke or death within 30 days.

“Most patients who have a blockage don’t go on to surgery,” Dr. Andrew Manganaro, Life Line Screening’s chief medical officer, said in the article. “Rather, they are managed with drug therapy and lifestyle changes. A positive test in one of [our] screenings would generally lead to a second ultrasound, not directly to surgery.”

Read the full article in the Wall Street Journal now.




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