Prevalence of Significant Carotid Artery Stenosis in Patients with Significant Atherosclerotic Peripheral Arterial Disease

Abstract

Peripheral artery disease (PAD) is a progressive disease occurring as a result of plaque accumulation (atherosclerosis) in the arterial system that carries blood to the extremities (arms and legs) as well as vital organs. The vessels that are most affected by PAD are the arteries of the lower extremities, the aorta, the visceral arterial branches, the carotid arteries and the arteries of the upper limbs.(5) Given the common aetiology of peripheral atherosclerosis occurring at different vascular sites, the presence of disease at one site increases the frequency of symptomatic and asymptomatic disease at another. Peripheral arterial disease (PAD) and carotid occlusive disease (COD) are both known to be specific manifestations of atherosclerosis. Carotid artery stenosis is usually caused by an atherosclerotic process and is one of the major causes of stroke and transient ischemic attack (TIA). (39) Because they both have a common cause, it is reasonable to be correlated with each other to a certain extent, and previous studies have shown that there is a correlation between the prevalence of PAD and COD.(3) Duplex UltraSound (DUS) is commonly used as the first step to detect carotid artery stenosis and to assess its severity. The peak systolic velocity measured in the carotid artery is the primary variable used for this purpose, together with the detection of carotid plaque and degree of stenosis.(54) The aim of the study is to detect the prevalence of significant carotid artery stenosis in patients with significant peripheral arterial disease. Our study included 50 patients with significant periphearlarteiral disease diagnosed by Peripheral Angiography (mean age: 61.6±8.5 years; range: 45-77 years; 44 male patients; 6 female patients). The study was conducted at Ainshams university hospital and KobryAlkobba Military hospital Cairo, Egypt, during the period from october 2014 to April2015. All Patients included in our study were having significant PAD diagnosed by Peripheral Angiography and referred to our hospitals complaining of symptoms and signs of PAD as limiting claudications, Rest pain, skin changes (as hair loss, thickened brittle nails, shiny and smooth skin, changes in skin color or muscular atrophy), ulceration, amputation, gangrene in lower