Femoral artery plaque: A simple ultrasound clue for severe coronary stenosis

With rising angiography costs and risks, we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.

To detect associations between atherosclerosis of peripheral arteries and coronary stenosis in patients with coronary heart disease (CHD).

The study included a total of 218 patients (63 ± 10.9 years of age; 54% male) with CHD subjected to coronary angiography and routine diagnostic assessment, including ultrasound imaging to assess the extent of peripheral atherosclerotic lesions. Receiver operating characteristic analysis and binomial logistic regression were used to detect the associations.

We demonstrated for the first time that the presence of atherosclerotic plaque with ≥ 70% stenosis in femoral arteries was associated with significant coronary stenosis, with 93% sensitivity and 90% specificity, and thus can be used as an additional diagnostic marker for coronary stenosis. The data indicated associations between femoral artery atherosclerosis and atherosclerotic lesions of coronary arteries, with a high correlation coefficient r = 0.8 (P < 0.05). The presence of an atherosclerotic plaque in the femoral arteries with ≥ 30% or ≥ 70% stenosis was associated with a 30- or 70-fold higher odds ratio of coronary stenosis, respectively.

For resource-limited clinics, our findings suggest skipping carotids - femoral ultrasound alone may suffice to rule out severe CHD. Ultrasound imaging femoral artery atherosclerosis provides a simplified approach for patient stratification.