From the Guidelines
The frequency of repeat vascular studies should be individualized based on the specific condition being monitored, with the most recent guidelines recommending intervals such as every 3-5 years for mild aortic regurgitation, every 1-2 years for moderate disease, and every 6-12 months for severe asymptomatic aortic regurgitation 1. The decision on how often to get repeat vascular studies depends on various factors including the type and severity of the vascular condition, the presence of symptoms, and the risk of disease progression.
- For patients with aortic regurgitation, the European Heart Journal guidelines suggest the following intervals:
- Mild aortic regurgitation: every 3-5 years
- Moderate aortic regurgitation: every 1-2 years
- Severe asymptomatic aortic regurgitation: every 6-12 months
- For patients with Marfan syndrome, the 2024 ESC guidelines recommend:
- At least annual transthoracic echocardiography (TTE) for patients with an aortic root diameter <45 mm in the absence of additional risk factors
- At least every 6 months TTE for patients with an aortic root diameter <45 mm in the presence of additional risk factors
- At least every 6-12 months TTE for patients with an aortic root diameter ≥45 mm in the absence of additional risk factors
- Complete peripheral vascular and thoracoabdominal aortic imaging by CMR or CCT and DUS at the first evaluation, and subsequently every 3-5 years if stable 1. It is essential to consider the individual patient's risk factors, symptoms, and disease progression when determining the frequency of repeat vascular studies, as these factors can influence the optimal interval for monitoring and may require more frequent or less frequent assessments 1.
From the Research
Vascular Study Frequency
There is no direct evidence in the provided studies to determine the frequency of repeat vascular studies.
Related Recommendations
However, the studies provide recommendations for antithrombotic therapy and treatment in patients with peripheral artery disease (PAD) and those undergoing vascular procedures:
- Aspirin is recommended for patients with PAD, with or without clinically manifest coronary or cerebrovascular disease 2.
- Dual antiplatelet therapy with aspirin and clopidogrel may be considered in certain cases, but the benefits are counterbalanced by an increased risk of bleeding 3, 4.
- The optimal duration of dual antiplatelet therapy after peripheral artery angioplasty or stenting is not well established, but at least four weeks is recommended after infrainguinal stent implantation 4.
Study Findings
The studies also report on the outcomes of revascularization versus initial medical therapy in patients with stable ischemic heart disease:
- Revascularization was not associated with a reduced risk of death, but was associated with a reduced risk of nonprocedural myocardial infarction and unstable angina 5.
- The use of antithrombotic agents, such as rivaroxaban and aspirin, has been shown to reduce the risk of major adverse cardiovascular events in patients with PAD 4.
Key Points
Key points to consider:
- The frequency of repeat vascular studies is not directly addressed in the provided studies.
- Antithrombotic therapy and treatment recommendations vary depending on the patient's condition and procedure undergone.
- Further studies are needed to establish the optimal treatment and follow-up strategies for patients with PAD and those undergoing vascular procedures 3, 6, 4.