[Screening strategies for the diagnosis of asymptomatic arterial lesions in patients with atherothrombosis].
Atherosclerosis is a ubiquitous inflammatory disease. Patients presenting an acute atherothrombotic event (acute coronary syndrom, stroke, aortic aneurysm, ...) have an increased risk of events in remote arterial territories affected by atherosclerosis. These patients could benefit from systematic screening of asymptomatic atherosclerotic lesions to avoid these complications. For each atherosclerotic territory (coronary artery, carotid artery, aorta, peripheral arteries including renal arteries), we review the methods for screening asymptomatic atherothrombotic lesions which could justify specific treatments: coronary artery stenosis > or = 50%, carotid artery stenosis > or = 60%, renal artery stenosis > or = 50%, and abdominal aortic aneurysm > or = 30 mm. This review shows that non invasive methods (ie, echography, tomodensitometry) are widely available for diagnosis of asymptomatic lesions in carotid and renal arteries, and in the aorta. Despite its invasive caracteristic, coronarory angiography remains the gold-standard for the diagnosis of coronary artery disease. However, cardiac multi-slices CT-scan appears a promising technique for asymptomatic patients.
Varenne
O
O
Service de cardiologie, hôpital Cochin, Paris. olivier.varenne@cch.ap-hop-paris.fr
Touzé
E
E
Collet
J P
JP
Raoux
F
F
Boissier
C
C
Carpentier
P H
PH
Alpérovitch
A
A
Mas
J L
JL
Montalescot
G
G
D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003327:Coronary Disease / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008403:Mass Screening; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity