It seems to me that one of the questions we might ask is the question of
whether more patients with disease are getting referred for appropriate
(i.e. ICAVL lab)testing after life line comes through a community. As it
is we are waiting for patients to have some sort of symptom (yes, some
have called bruit a symptom) before we test them. I cannot forget a
friends mother who stroked out from undiagnosed carotid disease and
needed full time care for 7 more years until she died. Perhaps carotid
screening could have prevented that one case. I know for myself that
when I get a screened patient for full testing and they "only" have a
tortous artery or just a forty percent stenosis, I feel fine about it
and would rather the screening service sent marginal patients than
missed significant disease.
I knew a radiologist in socal a few years ago who company did 2400
carotid screens a week. 1.5 percent had "significant" stenosis and were
advised to see there doctor etc, etc. I realized that of the 1872
patients per year that he found with significant disease his testing
might prevent a large number of strokes.
I still think this is a good thing to do - if I could figure out how to
put a computerized non-touch OPG in every drugstore for a twenty-five
cent screen, I would do it tomorrow. Stroke rehabilitation cost over 25
billion dollars a year in this country alone.
Sorry for the long one, but I'm passionate about helping to prevent