Incidence of asymptomatic carotid stenosis in cases of peripheral arterial occlusive disease – colour-duplex scan study

Objective: to investigate the incidence of asymptomatic hemodynamically significant carotid stenosis (CS) in cases of peripheral arterial occlusive disease (PAOB).

Methods: Prospective carotid Colour-Duplex scan (Toshiba Corevision SSA 350A) was performed in 107 patients with PAOB of lower and upper extremities. The occlusive changes in peripheral arteries were classified as unisegmental and multisegmental occlusive disease.

Results: PAOB of lower extremities was present in 99, upper extremity artery disease in 3 and both in 5 patients. CS was found in 25 patients, 20 in cases of lower extremity arterial disease. Lower extremity PAOB was unisegmental in 52 (52.5%) and multisegmental in 47 (47.5%) patients. Out of 52 patients with unisegmental disease 9 (17.3%) had significant CS, while out of 47 patients with multisegmental disease 11 (23.4%) had significant CS. No significant difference between those groups (χ2=0,569; DF=1, p>0,05). CS was found in 1 out of 3 patients with upper extremity PAOB and in 4 out of 5 patients with PAOB of both upper and lower extremities. The prevalence of CS in cases of both lower and upper extremity PAOB was significantly higher (80%) than in those with isolated lower extremity (20,2%) or isolated upper extremity arterial disease (33,3%).

Conclusions: Significantly high incidence of CS was found in cases of PAOB, especially in group of multisegmental occlusion of lower or upper extremity arteries. This synergy is highly expressed in cases of combined occlusion of upper and lower extremity arteries. It is necessary to perform carotid Colour-Duplex scan in cases of PAOB.