Occult carotid artery disease in patients who have undergone coronary angioplasty.
OBJECTIVE
The aim was to evaluate the prevalence of asymptomatic mild (30-49%), moderate (50-69%) and severe (70-99%) ICA stenosis in patients who underwent previous coronary angioplasty (PTA).


METHODS
After obtaining ethics committee approval, 144 consecutive patients aged between 65 and 75 years were invited for carotid Duplex evaluation with a linear 6 MHz array transducer by trained vascular sonographers within a single unit. A peak systolic velocity >230 cm/s in the ICA was considered as significant (>70% stenosis).


RESULTS
Of the 144 patients approached, 117 (81%) attended (male:female ratio 3.2:1, age range 65-75 years, median age 71 years). Duplex ultrasound revealed one occlusion, 70% or more ICA stenosis in three patients (2.6%), 50-69% stenosis in 12 patients (10.3%) and 30-49% stenosis in 29 patients (24.8%).


CONCLUSIONS
Carotid artery disease with a luminal stenosis of 30% or more is common in patients who underwent previous PTA. The yield of significant ICA stenosis (70% or more), which would benefit from carotid endarterectomy according to the Asymptomatic Carotid Surgery Trial is low. Recommendation for initial screening and subsequent follow-up Duplex examination for evaluation of disease progression of such cohorts remains debatable.
Fassiadis
Nicholas
N
Department of Vascular Surgery, King's College Hospital, London, UK.
Adams
Kate
K
Zayed
Hany
H
Goss
David
D
Deane
Colin
C
Maccarthy
Phillip
P
Rashid
Hisham
H
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex