Annals of vascular surgery
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We present preliminary results and analysis of a screening program that has been offered at a community-based hospital since July 2004. The program includes a quick carotid ultrasound study, abdominal aortic ultrasound imaging, and measurement of bilateral ankle/brachial indices (ABI). From July 2004 through January 2006, 1,719 patients were screened, including 1,094 (64%) women and 652 (36%) men. ⋯ This nonselective vascular screening program attracted many new patients into the health-care system. The open/endovascular procedure yield was low, but early disease detection was significant, causing numerous patients to be referred for additional testing and risk factor modification programs. These preliminary data suggest that community-based vascular screening programs play a key role in early vascular disease detection and provide the potential for prevention of disease progression while, at the same time, building sustainable business for hospitals and physicians.
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The etiology of spontaneous dissection of the carotid and vertebral arteries without antecedent trauma remains unclear. The goal of this 10-year review was to examine factors regarding presentation, diagnosis, treatment, and outcome for all patients at our institution who were diagnosed with spontaneous carotid dissections (SCD) or spontaneous vertebral dissections (SVD) with no prior trauma history. A retrospective chart analysis was performed involving all discharges from UCSD Medical Center from 1995 to 2005. ⋯ Radiographic evidence of cerebral infarction on discharge had a stronger correlation with clinical deficits in SCD. Although there were only two cases, those treated with endovascular therapy in the setting of SCD suffered complications related to the intervention. On discharge, there did not seem to be a correlation between persistent neurologic deficits and radiographic evidence of infarction in SVD reflecting that recovery after these episodes may not be predictable based on the appearance of the infarction.