title: Screening for asymptomatic carotid stenosis in patients with peripheral vascular disease: a prospective study and risk factor analysis.
abstract: Screening for asymptomatic carotid artery stenosis using color flow duplex scan was performed on 186 Chinese patients with peripheral vascular disease. They consist of 121 male and 65 females, with a mean age of 70.6 years. A carotid bruit was present in 43 (23.1%) of the patients. Internal carotid artery stenosis of 70% or greater was detected in 46 patients (24.7%) including six total occlusions. Another 79 patients (42.5%) had internal carotid artery stenosis in the 30-69% range. Significant internal carotid artery stenosis was associated with age, male sex, the quantity and duration of smoking and a carotid bruit, and inversely with cholesterol, triglyceride and VLDL. Age, the number of cigarettes consumed per day, and carotid bruit were independent significant predictors of > or =70% internal carotid artery stenosis on logistic regression analysis. The degree of internal carotid artery stenosis is more severe in patients with a carotid bruit, and correlated positively with age (P<0.01), the number of cigarettes smoked (P = 0.04), and the duration of smoking (P = 0.03). Multiple linear regression analysis showed that only the age of the patient bears a significant relationship with the degree of internal carotid artery stenosis (P<0.01). There was no relationship between the degree of lower limb ischemia with carotid stenosis. The prevalence of > or =70% internal carotid artery stenosis in a high risk population with peripheral vascular disease was 24.7%. Routine duplex screening is worthwhile in this group of patients, particularly in male, elderly smokers.
authors.affiliation: Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, China. wkcheng@hku.hk
authors.forename: S W
authors.initials: SW
authors.lastname: Cheng
authors.forename: L L
authors.initials: LL
authors.lastname: Wu
authors.forename: A C
authors.initials: AC
authors.lastname: Ting
authors.forename: H
authors.initials: H
authors.lastname: Lau
authors.forename: J
authors.initials: J
authors.lastname: Wong
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color