J Korean Med Sci.  2010 Aug;25(8):1167-1170. 10.3346/jkms.2010.25.8.1167.

Prevalence of Asymptomatic Critical Carotid Artery Stenosis in Korean Patients with Chronic Atherosclerotic Lower Extremity Ischemia: Is a Screening Carotid Duplex Ultrasonography Worthwhile?

• Yun WS
• Rho YN
• Park UJ
• Lee KB
• Kim DI
• Kim YW

• KMID: 1714037
• DOI: http://doi.org/10.3346/jkms.2010.25.8.1167

Abstract

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.

Keyword

Duplex ultrasonography; Peripheral Vascular Diseases; Carotid Stenosis

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
Atherosclerosis/complications
Carotid Stenosis/complications/epidemiology/*ultrasonography
Chronic Disease
Coronary Artery Disease/diagnosis
Demography
Female
Humans
Ischemia/complications
Lower Extremity
Male
Middle Aged
Peripheral Arterial Disease/*complications/surgery
Predictive Value of Tests
Prevalence
Republic of Korea/epidemiology
Risk Factors
*Ultrasonography, Doppler, Duplex

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