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PubMed · 9535286

Fast tracking carotid endarterectomy: practical considerations.

P E Collier
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Abstract

The diagnosis-related groups (DRG) and managed care economics have encouraged physicians to be more cost and resource efficient. In response to this demand, a fast track program for elective carotid endarterectomies has been established at Sewickley Valley Hospital. The essential components of this four-step program are operation based on duplex ultrasonography alone, same-day admission, a short recovery room stay to limit intensive care use, and discharge on the first postoperative day. Overall, 79% of patients for elective carotid endarterectomy successfully completed all four steps of the protocol at our institution. This has resulted in marked cost savings.

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Carotid StenosisCosts and Cost AnalysisElective Surgical ProceduresEndarterectomy, CarotidHumansLength of StayTreatment OutcomeUltrasonography, Doppler, DuplexJournal ArticleReview

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BibTeXRIS

P E Collier. 1998. Fast tracking carotid endarterectomy: practical considerations.. https://pubmed.ncbi.nlm.nih.gov/9535286/

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Low prevalence of significant carotid artery disease in Iranian patients undergoing elective coronary artery bypass.

BACKGROUND: Coronary artery bypass grafting ranks as one of the most frequent operations worldwide. The presence of carotid artery stenosis may increase the stroke rate in the perioperative period. Routine preoperative noninvasive assessment of the carotid arteries are recommended in many institutions to reduce the stroke rate. METHODS: 271 consecutive patients undergoing coronary artery bypass grafting at Shaheed Madani hospital of Tabriz, Iran (age, 58.5 Y; 73.1% male) underwent preoperative ultrasonography for assessment of carotid artery wall thickness. RESULTS: Plaque in right common, left common, right internal and left internal carotid arteries was detected in 4.8%, 7.4%, 43.2% and 42.1% of patients respectively. 5 patients (1.8%) had significant (<50%) and 3 (1.1%) patients had critical (<70%) stenosis in internal carotid arteries. Plaque formation in common carotid was not significantly different between two genders but the stenosis of left internal carotid was more frequently seen among men. Patients with plaques in right or left internal carotid arteries were significantly older. CONCLUSION: Consecutive Iranian patients undergoing elective coronary artery bypass surgery show a very low prevalence of significant carotid artery disease.

Carotid Stenosis↗