da Silva Alcides Alves, Moro André Brusamolin, Toregeani Jeferson Freitas
Centro Universitário da Fundação Assis Gurgacz - FAG, Cascavel, PR, Brasil.
Universidade Estadual do Oeste do Paraná - UNIOESTE, Cascavel, PR, Brasil.
J Vasc Bras. 2023 Aug 7;22:e20220084. doi: 10.1590/1677-5449.202200841. eCollection 2023.
Carotid arteries are frequently the site of pathologies, the most common being atherosclerosis, which may result in the formation of plaques, causing stenosis. Doppler ultrasound is currently the exam of choice for assessment of the carotid arteries in asymptomatic patients to screen for and diagnose vascular lesions. Current guidelines recommend screening patients who have risk factors for carotid stenosis and who are able and willing to undergo medical treatment and/or carotid intervention. Screening asymptomatic patients in the general adult population who have no significant risk factors is not recommended.
To assess whether medical experts rely on the literature to request Doppler ultrasound for screening.
A retrospective selection of patients was performed based on requests for carotid ultrasound. The data collected were computed and analyzed using RStudio version 1.3.959.
The request was evaluated as appropriate as long as the patients presented at least one risk factor for carotid plaques. Fifty-five out of 152 patients met criteria for carotid screening. The most frequent indication in the study population was vascular check-up. Arterial hypertension was the most prevalent risk factor. Vascular surgery specialists were more likely to order the exam correctly (odds ratio for correct indications: 3.52 [CI 1.14 - 10.87], with p=0.02). The rate of correct Doppler ultrasound requests was 36% (95%CI 29 to 42%).
An excess of requests for carotid ultrasound screening was found in this study. Vascular surgeons more often requested the test correctly.
颈动脉常常是病变发生的部位，最常见的是动脉粥样硬化，这可能导致斑块形成，进而引起狭窄。目前，多普勒超声是无症状患者颈动脉评估的首选检查方法，用于筛查和诊断血管病变。现行指南建议对有颈动脉狭窄危险因素且能够并愿意接受药物治疗和/或颈动脉干预的患者进行筛查。不建议对无明显危险因素的一般成年无症状人群进行筛查。
评估医学专家是否依据文献要求进行多普勒超声筛查。
根据颈动脉超声检查申请对患者进行回顾性选择。收集的数据使用RStudio 1.3.959版本进行计算和分析。
只要患者至少有一项颈动脉斑块危险因素，该检查申请就被评估为合理。152例患者中有55例符合颈动脉筛查标准。研究人群中最常见的指征是血管检查。动脉高血压是最普遍的危险因素。血管外科专家更有可能正确开具检查单（正确指征的比值比：3.52 [CI 1.14 - 10.87]，p = 0.02）。正确的多普勒超声检查申请率为36%（95%CI 29至42%）。
本研究发现颈动脉超声筛查申请过多。血管外科医生更常正确开具该项检查申请。
