[Arteriosclerotic changes in the carotid arteries in patients with hypersensitive carotid sinus reflex]

Thirty-seven patients (15 female, 22 male; aged 46-89 years, mean age 68.8 years) with III or IV grade carotid sinus reflex carotid arteries were investigated by sonography (B-scan and CW-Doppler). It was demonstrated that stenoses or arteriosclerotic plaques, localized in the region of the carotid bulb or bifurcation, were present on both sides in 27 patients and on one side only in four patients. Five patients did not show these changes and four of them had thickening of common carotid artery endothelium. Thus, vascular changes occurred in 35 patients. Occlusions and stenoses greater than 50% were visible in five patients. Primarily bilateral changes were shown as well as unilateral and bilateral pathologic reflex response; main localization was the posterior wall of the carotid bulb. Thus, arteriosclerotic changes seem to be important in the development of pathologic carotid sinus reflex. Cerebral complications (left-sided PRIND) occurred in one patient who did not have high degree carotid stenosis. In comparison to other authors who investigated only with CW-Doppler a much higher rate of arteriosclerotic wall changes and a greater occurrence of bilateral changes could be demonstrated by application of the highly sensitive B-scan sonography.