Healthcare Organizations Partner for Free Screening Event
Baptist Cardiac & Vascular Institute, Cook Incorporated, and the American Vascular Association promote early detection and treatment of vascular disease.
Many of the most debilitating vascular complications can be effectively prevented and cured with early detection, diagnosis, and treatment. The American Vascular Association (AVA) Screening Program has established itself as the largest, most comprehensive population-based screening for vascular disease. An AVA screening event was jointly hosted in Miami, Florida, on March 18, 2006, by the Baptist Cardiac & Vascular Institute (BCVI) and the AVA. Funded through an unrestricted grant to the foundation by Cook Incorporated (Indianapolis, IN), 199 men and women aged 60 years and older were screened for abdominal aortic aneurysms, carotid artery disease, and peripheral arterial disease at no cost to the participant. Endovascular Today interviewed Barry T. Katzen, MD, about the event.
Endovascular Today: How did BCVI alert the community to this opportunity, and how did you determine who would receive appointments?
Dr. Katzen: The AVA placed several advertisements in local papers (Figure 1), and the spots filled up extremely quickly. When the participants called for appointments, they answered several prescreening questions over the phone to ensure that they were in the right age category (60 years or older) and had at least one significant risk factor. This front-end filtration prescreening process enabled BCVI to significantly improve the benefit of screening and to detect more disease. Participants who were candidates were given appointments, during which time a brief history was taken to detect when their symptoms were first experienced. This streamlined method of filtration was one of the resources that the AVA brought to the screening program and resulted in higher detection of disease than other screenings we have done here at BCVI.
Endovascular Today: What was the screening process, and what imaging modality was employed?
Dr. Katzen: Screenings were conducted to detect carotid artery disease, aortic aneurysm disease, and peripheral arterial disease. We had six stations for the screenings, each with a technologist and a nurse. The noninvasive, painless, and quickly administered screening tests included an aortic ultrasound scan for abdominal aortic aneurysms, a carotid artery ultrasound duplex scan for carotid artery disease, and measurement of the ankle-brachial index to detect peripheral arterial disease (Figure 2). The patients did not have complete carotid examinations, nor did they have complete abdominal ultrasounds–our screening was limited to detection of disease.
When we reviewed the results, we asked the participants if they would like us to send their information to their doctors. If there was a positive result, we made specific note of that. At the end of the procedure, every participant sat down with a physician volunteer (vascular surgeons and radiologists from BCVI), and their findings were reviewed. The whole process took about 15 minutes per participant.
Endovascular Today: What were the costs involved?
Dr. Katzen: Although there was no cost to the participant, it required a significant amount of financial support to do this. Eleven BCVI physicians volunteered for the screenings, and the noninvasive lab technologists and nurses were paid through a grant from the AVA and Cook Incorporated.
Endovascular Today: What were the results of the screening?
Dr. Katzen: We got very high marks from the AVA in terms of the way the screening was conducted and the positive results. A total of five patients were diagnosed with abdominal aortic aneurysms, and a total of five were diagnosed with carotid artery disease. A total of 31% of patients screened for peripheral arterial disease had an ankle-brachial index <.90 (Table 1). Also, because participants had scheduled appointments, the screening was very efficient and led to a detection rate that was significantly higher than the blind screenings that we have done at community events or the Society of Interventional Radiology's Legs for Life, here at the Institute. At our previous screenings, only about 2% to 3% of participants for peripheral arterial disease had an ankle-brachial index <.90.
Endovascular Today: Will BCVI hold another screening event in the future?
Dr. Katzen: I would love to do this again, but it requires great financial resources; it is definitely a public service. It was a major institutional commitment to commit physicians to take this time.
Barry T. Katzen, MD, is from the Baptist Cardiac & Vascular Institute, Miami, Florida. Dr. Katzen may be reached at (786) 596-5990; firstname.lastname@example.org.