Key result
In patients with peripheral artery disease, multilevel lesions were associated with a higher incidence of severe internal carotid artery stenosis compared to iliac and infrainguinal lesions.
Why the study?
The study aimed to investigate the association between carotid artery stenosis and peripheral artery disease using screening carotid ultrasonography.
Does preoperative screening by carotid ultrasonography identify severe asymptomatic carotid artery stenosis in patients with peripheral artery disease?
Cross-Sectional (n=231)
No
Does preoperative screening by carotid ultrasonography identify severe asymptomatic carotid artery stenosis in patients with peripheral artery disease?
Preoperative carotid ultrasonography screening in PAD patients, especially those with multilevel lesions, older age, CKD, or CVD, can effectively identify severe asymptomatic carotid artery stenosis.
Answers are grounded in this paper and cite their sources.
Multilevel PAD lesions linked to higher severe ICA stenosis; may support targeted screening but leaves outcome benefit open.
We aimed to investigate the association between carotid artery stenosis and peripheral artery disease (PAD) by screening carotid ultrasonography (CUS).From January 2012 to December 2015, 231 consecutive patients who had undergone preoperative CUS for PAD were included in this study. A radiologist assessed the degree of internal carotid artery (ICA) stenosis by using the North American Symptomatic Carotid Endarterectomy Trial (NASCET). Severe (>70%) ICA stenosis was evaluated based on the type of vascular surgery, PAD lesion, and ankle-brachial index (ABI). Data were analyzed using multiple logistic regression analysis and the χ test.Among 231 PAD patients, multilevel lesions revealed significantly higher incidence of severe ICA stenosis than iliac and infrainguinal lesion (22.5% vs 9.4% vs 8%: P = .016). Age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.00-1.12: P = .035), chronic kidney disease (CKD, OR: 6.19, 95% CI: 2.04-45.04: P = .013), and cerebral vascular disease (CVD, OR: 4.08, 95% CI: 1.13-16.46: P = .037) were significant risk factors of severe ICA stenosis in multivariate analysis. Prevalence of severe ICA stenosis according to ABI in PAD was not significant.Preoperative screening by CUS provides valuable information onasymptomatic carotid artery stenosis (ACAS) that can identify severe ACAS patients who are at high risk of stroke and to consider more intensive management of carotid disease in PAD patients. CUS can be a useful noninvasive preoperative screening imaging tool for PAD patients with multilevel lesions, aged > 65 years old, with CKD and CVD.
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Jung et al. (2019) conducted a cross-sectional in Peripheral artery disease (n=231). Screening carotid ultrasonography was evaluated on Severe internal carotid artery stenosis (>70%) in multilevel lesions compared to iliac lesions (p=0.016). In patients with peripheral artery disease, multilevel lesions were associated with a higher incidence of severe internal carotid artery stenosis compared to iliac and infrainguinal lesions.
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