Extracranial carotid artery stenosis: prevalence and associated risk factors in elderly stroke patients

The degree of arterial stenosis in both the right and left extracranial (common and internal) carotid arteries (ECAS) was assessed in 118 elderly (65 years and older; male 66) stroke patients by a Duplex Pulsed Wave ultrasound system (ATL 500). Of these, 33 (28%) had severe stenosis (75-100%), 16 (14%) had moderate stenosis (30-74%) and 69 (58%) had no or minimal stenosis (0-29%). Overall, 34% (n = 40) of strokes were associated with moderate or severe stenosis in the ipsilateral extracranial carotid artery. Multivariate logistical regression analysis showed a significant (P less than 0.05) positive correlation between ECAS (as assessed in either artery) and ischaemic heart disease, systolic blood pressure and male sex (multiple correlation coefficient, r = 0.240). The results were similar when the analysis was repeated for ECAS in the 'clinically significant' (maximal stenosis ipsilateral to the stroke) arteries only (multiple correlation coefficient, r = 0.276). The relationships, however, were weak, suggesting that other factors not identified in this study are more important aetiological factors for extracranial carotid artery atherosclerosis in the elderly.