Key result
Chronic kidney disease is linked to ~9-fold higher odds of severe carotid stenosis in PAD.
Why the study?
Patients with peripheral arterial disease are at increased risk of asymptomatic carotid artery stenosis, but the prevalence and associated risk factors require further evaluation.
Observational (n=147)
No
Asymptomatic carotid artery stenosis is highly prevalent in patients with peripheral arterial disease, suggesting that non-invasive ultrasound screening in high-risk subgroups (older age, CKD, low ABI) can aid in early detection of cerebrovascular risk.
May support targeted carotid screening in PAD with CKD; hypothesis-generating and requires prospective validation before practice change.
Background: Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis and is frequently associated with involvement of other vascular territories including the carotid arteries. Patients with PAD are at increased risk of asymptomatic carotid artery stenosis (ACAS), which may predispose them to ischemic strokeand cerebrovascular complications. The present study was conducted to determine the prevalence of ACAS in patients with PAD and evaluate associated risk factors.Methodology: This hospital-based observational study was conducted in the Department of General Medicine at Sree Mookambika Institute of Medical Sciences from February 2025 to January 2026. Patients diagnosed with peripheral arterial disease based on ankle-brachial index (ABI) were included in the study. Carotid duplex ultrasonography was performed using a high-resolution B-mode ultrasound machine with a 7.5 MHz linear-array transducer to assess carotid artery stenosis and plaque characteristics. Clinical variables including age, smoking, diabetes mellitus, hypertension, chronic kidney disease, andcoronary artery disease were analyzed. Statistical analysis was performed using Chi-square and Fisher’s exact tests.Results: A total of 147 patients were evaluated, with a mean age of 56 ± 9.72 years, and 87% were males. Smoking and hypertension were highly prevalent among study participants. Multilevel arterial disease was common. Advanced age (>63 years), chronic kidney disease, previous cerebrovascular disease, and ABI <0.4 showed significant association with severe carotid artery stenosis. Carotid duplex ultrasonography effectively identified significant asymptomatic carotid artery disease and vulnerable plaques.Conclusion: Asymptomatic carotid artery stenosis is common among patients with peripheral arterial disease. Carotid duplex ultrasonography isa valuable non-invasive screening tool for early detection of carotid artery disease in high-risk PAD patients.
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J et al. (2026) conducted an observational in Peripheral arterial disease (n=147). Peripheral arterial disease was evaluated on Prevalence and severity of asymptomatic carotid artery stenosis (ACAS). Asymptomatic carotid artery stenosis was highly prevalent among patients with peripheral arterial disease, with chronic kidney disease strongly predicting severe carotid stenosis (OR 9.37).
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