Expansion of the SAAAVE Protocol with Addition of Ultrasound Scans of the Femoral and Carotid Arteries to Prevent Heart Attacks and Strokes

Abstract

Introduction

Heart attacks and strokes are the leading cause of death and disability. Most occur without warning. To prevent heart attacks and strokes in seniors, in this article I propose an expanded SAAAVE program that includes an ultrasound scan of the carotid and femoral artery along with that of the aorta. A positive scan of any of these would trigger a metabolic and cardiac evaluation, allowing early management of systemic arteriosclerosis and preemptive intervention for critical disease of the coronary artery as well as the carotid artery and aorta.

Method

The carotid artery, femoral artery, and aorta are rapidly scanned. Positive studies are referred for full follow-up examinations and metabolic/cardiac evaluations. Medicare does cover some aortic scans and the indicated follow-up tests and care that result from all scans.

Results

Medical and interventional management can prevent fatal heart attacks from known coronary artery disease. Intervention for significant carotid disease that is present in 7.5% of seniors could prevent more than 200,000 strokes and save nearly 13 billion dollars annually. Screening for abdominal aortic aneurysm has decreased deaths from ruptured aneurysms, and statin therapy for dyslipidemia can reduce future cardiac events.

Conclusions

This simple, rapid, one-stop screen for seniors has the potential to prevent death and disability from heart attack, stroke, and ruptured abdominal aortic aneurysm