COST-EFFECTIVENESS OF COLOR DUPLEX SONOGRAPHY COMPARED WITH ANGIOGRAPHY OF THE PELVIS AND LOWER-LIMB

The present investigation was performed to assess the clinical consequ ences, utility and efficacy of colour duplex sonography (CDS) compared with angiography as a preoperative examination in aorta, pelvis and l ower limb, and thus to estimate the cost-effectiveness of CDS. CDS was additionally performed in 53 consecutive patients referred for pre-op erative angiography of the lower limb. The results for 49 patients wer e reviewed and compared to assess the technique's clinical utility. Th e costs of the two methods and the consequences of inappropriate treat ment were assessed. In 15 patients inadequate diagnoses were obtained at CDS. If surgery had been performed solely on the basis of the ultra sonographic diagnosis, repeat surgery would have been necessary in 9 p atients. In a further 3 patients necessary surgery would not have been performed. Two patient would have been overtreated (unnecessary surge ry instead of percutaneous transluminal balloon angioplasty). To corre ct the initial incorrect diagnosis the estimated yearly cost would be approximately 1.3 million Swedish crowns. In addition, complications a nd discomfort could be anticipated for the patients. Because of its lo w sensitivity CDS ist not cost-effective as a preoperative investigati on of arteries of the pelvis and lower limb.