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Hi Mike, The 400 that came to the stroke fair last year were not the group we had obviously hoped for. 5 out of 400.The very young and the very old often do not have any carotid plaques. We all know how many people have strokes every year and more that 75% of most of our patients have less than a 50% stenosis on any given day in a lab.
Or maybe it is just California stats.  We did not refer any patient for an exam that had a noticable intimal thickening and nor do you measure anything with a screen. I encourage you to look at the general public that shows up for a free scan and see how many have disease. It just may surprise you. We are having our stroke fair again Oct 5th. I will report our finds if anyone would be interested.
 
Denise Levy, RVT, RDMS, RDCS
San Jose, CA Regional Medical Center
Registered since 1975.
 
On 9/27/07, Mike Elkins <[log in to unmask]> wrote:

"5 out of 400" or "very little disease " is misleading.  If you're screening for carotid lesions and not looking at IMT, you're missing many patients at high risk for stroke or MI.  2 out of 3 of ALL OF US will die from CVD.  We lose 50% of men and 66% of women in the transition from primary to secondary care.  Finding carotid lesions at a "screening" is like finding last year's eggs at an easter egg hunt.    

 

IMT will show subtle but significant changes EARLY in the life cycle of the disease.  Crestor is expected to get new labeling for regression.  How are you going to track changes? 

 

Mike


From: UVM Flownet [mailto: [log in to unmask]] On Behalf Of Denise Levy
Sent: Wednesday, September 26, 2007 9:38 PM
To: [log in to unmask]
Subject: Re: Screening??

 

I highly recommed a screening event in your community. We have a Health Fair or Stroke Fair at our hospital annually. We have 2 machines and 2 lines of visitors for screening. I follow the guidelines of ICVAL and a simple check is added to the carotid screen with a no mention to their doctor of the degree of disease.  We scanned 400 visitors from 11-4 PM and only 5 were referred to their doctors on the sheet.

Read over the ICVAL guidelines and scan the visitor looking at the screen while sitting in a chair. It is a great tool for educating the public and the majoirity of visitors that they are have very little disease. You should only do a quick up and down transverse and only sagittal if you see plaque. No pictures are taken nor any percentage of stenosis is given. Remember it is just a free look and open to the public. I would like to eventually apply for the ICVAL screening, we have several catagories of ICVAL testing.

 

Denise Levy, RVT, Regional Medical Center, San Jose, CA

 

On 9/25/07, Kerrie Cumming < [log in to unmask]> wrote:

The subject was brought up today if I would be interested in doing vascular screening tests at my current place of work.  I work for a vascular surgeons office and currently do "full" diagnostic vascular testing.  I'm not sure what to think, but I don't know if I could simply do a "screening" test.  I'm so used to being as thorough as possible, it would be hard for me to draw the line.  Although I feel "screening tests" are probably good for the public because you might catch something serious.  But then where would the results be sent? To the primary care doctor's office?  Who's responsible? Would the patients come back here to have the full test?  Would that be strange?  would we run into legality issues being a "full service" lab and a "screening" lab?  Any input would be welcome.  I hear ICAVL is going to try and set up accreditation for screening labs. 

   


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