Key result
In Korean patients with peripheral arterial disease, the prevalence of asymptomatic critical carotid artery stenosis was 14%, with age >65 years (OR 2.61) and concomitant coronary artery disease (OR 2.33) identified as significant predictive factors.
Observational (n=340)
No
Odds Ratio: 2.61 (95% CI 1.197–5.691)
p-value: p=0.016
Preoperative screening carotid duplex ultrasonography is clinically valuable in patients with peripheral arterial disease requiring revascularization, particularly those over 65 years old or with concomitant coronary artery disease, due to a 14% prevalence of critical asymptomatic carotid stenosis.
May support selective carotid screening in older PAD patients with CAD; leaves open whether routine use improves outcomes.
This study aimed to investigate prevalence of asymptomatic carotid artery stenosis (ACAS) in Korean patients with peripheral arterial disease (PAD) and identify predictive factors of ACAS in patients with PAD. Between 1994 and 2008, 546 patients who underwent bypass surgery due to PAD were identified in a single tertiary teaching hospital. Of those, 409 patients underwent preoperative screening carotid duplex ultrasonography (CDUS). Patients who had an episode of cerebrovascular event or previous carotid artery intervention were excluded and then a retrospective analysis was made of 340 patients. The degree of internal carotid artery (ICA) stenosis was determined by the criteria of Society of Radiologists in Ultrasound Consensus Conference. To determine the risk factors of ACAS, demographic, coexisting medical condition and lesion characteristics were tested with binary logistic regression model. The prevalence of > or = 70% ICA stenosis was 14%. ICA occlusion was detected in 7.1%. Multivariate analysis revealed age > 65 yr (OR: 2.610, 95% CI: 1.197-5.691) and coronary artery disease (CAD, OR: 2.333, 95% CI: 1.169-4.657) are predictive factors of > or = 70% stenosis. A PAD patient who needs revascularization, particularly, > 65 yr or has a concomitant CAD, can be a good candidate of screening CDUS.
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Yun et al. (2010) conducted an observational in Chronic atherosclerotic lower extremity ischemia (Peripheral Arterial Disease) (n=340). Age >65 years vs. Age ≤65 years was evaluated on Critical (≥70%) asymptomatic internal carotid artery stenosis (OR 2.610, 95% CI 1.197-5.691, p=0.016). In Korean patients with peripheral arterial disease, the prevalence of asymptomatic critical carotid artery stenosis was 14%, with age >65 years (OR 2.61) and concomitant coronary artery disease (OR 2.33) identified as significant predictive factors.
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