Screening for carotid stenosis in patients with ischaemic heart disease

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Vascular Surgery

Background:

• Ischemic heart disease patients often have concurrent carotid artery disease.
• Early detection of carotid stenosis is crucial for stroke prevention in this high-risk population.
• Current screening methods may not be integrated with cardiac procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of oblique cervical intra-arterial digital subtraction angiography (IA-DSA) for screening carotid artery stenosis.
• To assess the feasibility of performing this screening during routine coronary angiography.
• To determine the prevalence of significant carotid stenosis in patients undergoing coronary angiography.

Main Methods:

• Thirty consecutive patients undergoing coronary angiography for myocardial infarction work-up or post-revascularization follow-up were included.
• An oblique cervical IA-DSA was performed concurrently with coronary angiography.
• Conventional angiography was used for confirmation when stenosis was suspected.

Main Results:

• Three cases (10%) of severe carotid artery stenosis (70%, 75%, 90%) were detected in the right carotid bifurcation.
• One case of 75% stenosis showed ulceration.
• The procedure was safe, with no complications, and required less than 5 minutes and 20 ml of additional contrast media.

Conclusions:

• Cervical IA-DSA is a safe, efficient, and high-resolution method for screening carotid stenosis in patients undergoing coronary angiography.
• This integrated approach can identify significant carotid stenosis in a high-risk population, enabling timely intervention.
• The study supports the value of routine cervical IA-DSA screening in patients with ischemic heart disease.