New ESVS Guidelines recommend intraoperative ultrasound after CEA

Professor Eckstein, University Hospital Rechts der Isar, Munich, Germany, states that “This new guideline recommendation clarifies that intraoperative morphological control is worthwhile. In my practice, ultrasound imaging for completion control after CEA has become the standard of care, especially when surgery is performed under locoregional anesthesia. Intraoperative angiography is only needed if a cerebral problem is suspected."

The Guidelines are set to identify luminal thrombus after flow restoration, diagnose intimal flaps and diagnose residual stenoses during surgery.

The new recommendation is based on a meta-analysis by Knappich et al. 20212 that shows that both ultrasound imaging and angiography are associated with a reduced risk of death and stroke after CEA.

Professor Eckstein, University Hospital Rechts der Isar, Munich, Germany, states that “This new guideline recommendation clarifies that intraoperative morphological control is worthwhile. In my practice, ultrasound imaging for completion control after CEA has become the standard of care, especially when surgery is performed under locoregional anesthesia. Intraoperative angiography is only needed if a cerebral problem is suspected.”

“It is Medistim’s goal to develop a strong position for our transit time flow measurement (TTFM) and high-frequency ultrasound (HFUS) imaging devices within the Vascular market, including the CEA segment,” says Medistim’s President and CEO, Kari E. Krogstad. “The recommendation of ultrasound imaging as an alternative to the current gold-standard angiography marks another milestone for Medistim in our efforts to establish our HFUS technology for completion control in CEA. In the CIDAC study3, which was part of the Knappich meta-analysis2, Medistim’s MiraQ Vascular device was used, and it demonstrated the benefits of using HFUS compared to angiography. So far this year, our vascular product portfolio revenues have grown more than 40%, and with the support of these revised Guidelines we are in great position to continue this growth path.”

The new Guidelines will be presented at the ESVS conference in Rome the 21st of September just prior to Medistim’s lunch symposium titled “Completion control in vascular surgery: Lessons learned from the OR”, by Prof. Pirkka Vikatmaa, Helsinki University Hospital.

Reference links:
1) https://doi.org/10.1016/j.ejvs.2022.04.011
2) https://pubmed.ncbi.nlm.nih.gov/34430642/: Ann Transl Med. 2021Jul;9(14):1201. doi: 10.21037/atm-20-2931
3) https://doi.org/10.1016/j.ejvs.2020.02.017