title: Incidence of asymptomatic extracranial arterial disease.
abstract: Investigations of the incidence and the extent of the asymptomatic early stages of extracranial arterial disease (EAD) have been restricted for methodical reasons. Direct Continuous Wave-Doppler examination has given highly accurate results in the location and correct estimation of the degree of EAD both for the carotid (97%) and the vertebral arteries (90%), as shown from a detailed comparison with carotid (n = 604) and vertebral (n = 426) angiograms. Compared with this degree of reliability, the validity of normal auscultation for the diagnosis of EAD is shown to be poor: if bruits are taken as the only signs of associated EAD in patients with systemic atherosclerosis, only 27.6% in a group of 123 patients would have been correctly diagnosed. This parallels the number of false-positives (22.6%) in patients with normal results. The frequency and degree of EAD was studied by the use of direct Doppler examination in 2009 neurologically asymptomatic patients admitted either with severe vascular (n = 375) or coronary atherosclerosis (n = 262) or with high-risk factors (n = 1370). The frequency was significantly higher (32.8%) in patients with peripheral vascular disease than in those with coronary artery disease (6.8%) and in risk-factor patients (5.9%). The combination and degree of vessel involvement are presented in detail and their possible prognostic significance discussed.
mesh_terms: D000368:Aged; D001014:Aortic Aneurysm / Q000150:complications; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000209:etiology; D001161:Arteriosclerosis / Q000150:complications; D001314:Auscultation; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000175:diagnosis*; D003327:Coronary Disease / Q000150:complications; D003951:Diagnostic Errors; D004301:Doppler Effect; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014463:Ultrasonography; D014711:Vertebral Artery / Q000000981:diagnostic imaging