Asymptomatic carotid artery stenosis in patients with severe peripheral vascular diseases

BACKGROUND The prevalence of carotid artery stenosis (CAS) in the general population is not high enough to justify screening programs. This study was done to determine the prevalence of asymptomatic carotid artery stenosis (ACAS) among patients with severe peripheral vascular disease (PVD). METHODS Between March 2005 and February 2006, 54 consecutive patients with severe PVD admitted at a vascular surgery unit and underwent carotid duplex scanning in a prospective study. A questionnaire was used to collect data concerning known risk factors. Significant CAS was defined as a stenosis of 70% or greater. RESULTS The mean age was 62.5 years (51-72). Out of 54 patients, 2 (3.7%) had an occluded internal carotid artery. Significant CAS was found in 9 (16.7%) and its presence was correlated with diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, coronary artery disease, severity of symptoms, anklebrachial index, and carotid bruit. On multivariate analysis, only hypercholesterolemia and carotid bruit seemed to have independent influence. CONCLUSION The prevalence of significant ACAS is higher among patients with severe PVD. This patient population may indicate a suitable subgroup for screening of ACAS, especially when hypercholesterolemia and carotid bruit are present.