Screening of the internal carotid arteries in patients with peripheral vascular disease by colour-flow duplex scanning
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R B Klop1, B C Eikelboom, A C Taks
1Department of Vascular Surgery Stichting Doetinchemse Ziekenhuizen, Netherlands.
Insights
Major internal carotid artery disease (MICAD) affects nearly 15% of peripheral arterial disease (PAD) patients. Screening for MICAD in PAD patients is recommended due to its high prevalence.
Area of Science:
- Vascular Surgery
- Cardiology
- Radiology
Background:
- Peripheral arterial disease (PAD) is a common condition affecting arteries outside the brain and heart.
- Internal carotid artery disease (ICAD) is a significant risk factor for stroke.
- Assessing ICAD prevalence in PAD patients is crucial for comprehensive cardiovascular risk management.
Purpose of the Study:
- To determine the prevalence of major internal carotid artery disease (MICAD) in patients with peripheral arterial disease (PAD).
- To investigate the correlation between the severity of ICAD and PAD.
- To explore the relationship between MICAD and traditional cardiovascular risk factors.
Main Methods:
- A cohort of 416 consecutive patients with PAD was studied.
- Colour-flow duplex scanning was utilized to assess the extent of internal carotid artery disease.
- Major internal carotid artery disease was defined as 75% stenosis and/or occlusion.
Main Results:
- The prevalence of MICAD was 14.9% (62/416 patients), with 12.5% unilateral and 2.4% bilateral disease.
- No significant correlation was found between the severity of ICAD and PAD.
- MICAD prevalence was significantly higher in patients with obstructive PAD (16.0%) compared to aneurysm patients (4.7%).
- No correlation was observed between MICAD and hypertension, gender, age, diabetes mellitus, hypercholesterolemia, smoking, or ischemic heart disease.
Conclusions:
- A substantial proportion of patients with PAD have significant internal carotid artery disease.
- The findings suggest that PAD patients are a high-risk group for MICAD.
- Screening for high-grade stenosis in the carotid arteries of PAD patients is warranted to identify candidates for intervention.
Abstract:
The prevalence of internal carotid arterial disease was assessed in 416 consecutive patients with peripheral arterial disease (PAD). Colour-flow duplex scanning was performed to determine the extent of the disease. Major internal carotid artery disease (MICAD), meaning 75% stenosis and/or occlusion, was found in 14.9% (62) of the patients; 12.5% (52) had unilateral disease and 2.4% (10) had bilateral disease. In 7.7% (32) there was a stenosis of 75-99%. An occlusion was seen in 7.2% (30). No correlation was found between the severity of the internal carotid artery disease and the severity of the peripheral arterial disease. The 16.0% (60) prevalence in MICAD in patients with obstructive disease was significantly higher than the 4.7% (2) in aneurysm patients (p less than 0.05). The results show that there was no correlation between MICAD and the risk factors: hypertension, gender, age, diabetes mellitus, hypercholestolaemia, smoking and ischaemic heart disease. The high prevalence of MICAD in patients with PAD suggests that it would be useful to start a screening programme to determine if high grade stenosis should be operated upon.