SVS Guidelines Bundle

Follow-Up After Vascular Surgery Arterial Procedures

SVS GUIDELINES App Bundle brought to you fcourtesy of Guideline Central. All of these titles are available for purchase on our website, GuidelineCentral.com. Enjoy!

Issue link: https://eguideline.guidelinecentral.com/i/1309723

Contents of this Issue

Navigation

Page 2 of 7

Diagnosis Extracranial Carotid Artery ➤ After carotid endarterectomy (CEA) or carotid artery stenting (CAS), the Society for Vascular Surgery (SVS) recommends surveillance with DUS at baseline and every 6 months for 2 years and annually thereafter until stable (i.e., until no restenosis or in-stent restenosis [ISR] is observed in two consecutive annual scans). The first or baseline DUS should occur soon after the procedure, preferably within 3 months, with the goal of establishing a post-treatment baseline. Considering the small risk of delayed restenosis or ISR, some interval of regular surveillance (e.g., every 2 years) should be maintained for the life of the patient. (1-B) ➤ For patients undergoing CAS with diabetes, aggressive patterns of ISR (type IV), prior treatment for ISR, prior cervical radiation or heavy calcification, in addition to the baseline DUS the SVS recommends surveillance with DUS every 6 months until a stable clinical pattern is established and annually thereafter. (1-B) ➤ The SVS recommends that DUS after CAS include at least the following assessments (1-C): • Doppler measurement of peak systolic velocity (PSV) and end-diastolic velocity (EDV) in the native common carotid artery (CCA); in the proximal, mid, and distal stent; and in the distal native internal carotid artery (ICA). Modified threshold velocity criteria should be used to interpret the significance of these velocity measurements after CAS. • B-mode imaging should be used to supplement and to enhance the accuracy of velocity criteria to estimate the severity of luminal narrowing. Figure 1. Morphologic Patterns of ISR Based on B-mode Imaging Type I, focal ≤10 mm, end-stent lesions; Type II, focal ≤10 mm, intrastent lesions; Type III, diffuse >10 mm, intrastent lesions; Type IV, diffuse >10 mm, proliferative lesions extending outside the stent; and Type V, total occlusion.

Articles in this issue

Archives of this issue

view archives of SVS Guidelines Bundle - Follow-Up After Vascular Surgery Arterial Procedures