[Frequency of cervical arteriopathies demonstrated by a routinely conducted Doppler test on a patients consulting for a lower-limb arteriopathy. Results of a prospective study of 676 patients].
Routine cervico-encephalic Doppler examinations were conducted during a prospective study of 676 patients with lower limb arteriopathy. The population treated was defined precisely, mainly with respect to sex, age, recruitment factors, mode of discovery of the arteriopathy, lower limb arteriopathy severity stage as defined by Leriche and Fontaine, site of main lesions, vascular risk factors and the existence or absence of a clinical feature suggestive of an associated cervical arteriopathy. A lesional score was defined in order to evaluate results of Doppler in a simple, intelligible manner. This lesional score was determined as a function of each of the elements (numerically rated) to enable the population to be defined. Results of cervical Doppler were normal or showed only slightly stenotic lesions in 80 to 83% of cases, and a cervical arteriopathy in 13% of patients. Results had no effect on the measures to be taken in 87% of cases. Angiography of the cervical axes was performed in 10% of cases and preventive repair surgery on one or more axes supplying the brain was carried out in 6%. It is concluded that routine Doppler cervical examinations are unnecessary in cases of LLA, since the history and findings on clinical investigations enable selection of patients in whom results of Doppler are probably abnormal. In the absence of clinical signs suggestive of associated cervical arteriopathy, cervical Doppler tests demonstrate major carotid artery lesions in only 1 to 2% of cases, whereas under the critical situations defined this figure varies from 18 to 41%. Clinical examination suggests the probably diagnosis of a cervical arteriopathy associated with LLA, and the cervico-encephalic Doppler test assesses the degree of any stenosis present.
Becker
F
F
Lance
G
G
Melan
J
J
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis*; D003327:Coronary Disease / Q000150:complications; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012212:Rheology; D012306:Risk; D014463:Ultrasonography
Fréquence des artériopathies cervicales mises en évidence par un examen Doppler cervico-encéphalique réalisé a titre systématique sur un patient consultant pour artériopathie des membres inférieurs. Résultats d'une enquête prospective portant sur 676 patients.