Asymptomatic Carotid Artery Stenosis Screening in Patients with Lower Extremity Atherosclerosis: A Prospective Study

The prevalence of hypoechoic carotid plaques is greater in peripheral than in coronary artery disease and is related to the neutrophil count

“…[10][11][12] Plaques that appear with low echogenicity on B-mode ultrasound scanning have an increased lipid content that renders them more prone to rupture, whereas plaques with high echogenicity consist mainly of fibrin and collagen, which makes them more stable. 13,14 Although previous reports indicate that the prevalence of significant carotid stenoses is greater in PAD than in CAD subjects, [1][2][3][4][5] to our knowledge, no study has compared these two populations with respect to plaque echogenicity. Accordingly, we investigated this neglected area.…”

“…With respect to the coexistence of carotid stenoses with other arterial diseases, it seems to be more common and severe in peripheral arterial disease (PAD) than in coronary artery disease (CAD). [1][2][3][4][5] In particular, the Second Manifestations of ARTerial (SMART) disease study 4 showed that the prevalence of carotid stenosis Ն70% was 12.5% in PAD and only 3.1% in CAD. Similarly in another series, carotid stenosis Ն70% was present in 24.5% of PAD patients and in 11.1% of CAD patients.…”

Prevalence of carotid stenosis and silent myocardial ischemia in asymptomatic subjects with a low ankle-brachial index

“…2 The prevalence of a carotid stenosis Ͼ50% ranges between 2% and 11% depending on the characteristics of the population studied, [13][14][15] and is higher, between 14% and 36%, in patients with symptomatic PAD. 4,[16][17][18][19][20] The preva- lence found in our study is situated at the lower end of the range observed in patients with symptomatic disease. There is considerable debate regarding the value of population screening to detect the presence of asymptomatic carotid stenosis, and whether there is a specific subgroup that can benefit more from this strategy.…”

“…2 Due to this high risk, some authors and consensus documents have recommended the systematic search for occult coronary and cerebrovascular disease in this population. [3][4][5][6][7] Asymptomatic subjects with PAD also have an elevated risk of cardiovascular disease which, in some studies, parallels that of symptomatic individuals. 8 For that reason, and in order to improve risk stratification, ankle-brachial index (ABI) measurement has been recommended in subjects of intermediate risk.…”

Prevalence of significant carotid artery stenosis in Iranian patients with peripheral arterial disease

“…This finding is in contrast to that of previous studies disclosing a prevalence of greater than 70% carotid stenosis ranging 5%-24% in patients suffering from peripheral vascular disease. [4][5][6]8,[17][18][19][20][21][22][23] In a meta-analysis of nineteen studies, Ahmed and Al-Khaffaf concluded that prevalence of .70% asymptomatic carotid artery stenosis was 14% in patients with peripheral vascular disease. 7 This discrepancy may be explained by the fact that asymptomatic significant carotid stenosis occurs in elderly patients (age $ 65 years) with peripheral vascular disease.…”