ACTA FAC. MED. NAISS. 2005; 22 (3): 149-155

Original article

Zoran Rančić, Milan Jovanović Lidija Đorđevic-Jovanović, Goran Stevanović, Predrag Kovačević, Biljana Stošić, Vanja Pecić

Surgery Clinic, Clinical Center of Nis

SUMMARY

The aim of the paper is to determine the frequency of asymptomatic carotid stenosis in patients with atherosclerosis of lower extremities’ arteries and to answer the question whether early screening of asymptomatic disease in certain subgroups of patients is effective. The study included 109 patients with obliterated atherosclerosis of lower extremities. On the basis of ACAS criteria, we conducted color Doppler screening in all the patients. In 36.69% of patients, we discovered hemodynamic significant stenosis >=60% or occlusion; in 29% of patients we discovered stenosis >= 70%. Morphologic characteristics of the plaque were analyzed on 43 patients’ arteries with carotid artery stenosis ranging from 50-99%. In the majority of patients fibrolipid (44.18%) and fibrous plaque (23.26%) were present. In 58.14% of the plaques, the surface was irregular, and in 23.26% it was ulcerated. Additional examinations aimed at determining whether there was any correlation between asymptomatic carotid stenosis >=60% and occlusion, and certain characteristics of patients with obliterated atherosclerosis of lower extremities. Univariate analysis showed the association of hemodynamic significant stenosis of carotid arteries and previous vascular operations, age over 60, arterial hypertension, pedobrachial index (ABI) < 0.5 and carotid serum. By the application of multivariate logistic regression analysis, we found that this association refers only to carotid sum (t =0.50; p=0.01), whereby the sensitivity was 67%, and specifity 56%. Therefore, the conclusion is that limited early screening of carotid stenosis in neurological asymptomatic patients with symptomatic atherosclerosis of lower extremities, regarding certain subgroups of patients, is ineffective and unjustified. Key words: asymptomatic carotid stenosis, prevalence of carotid stenosis, obliterated atherosclerosis of lower extremities

Key words: optic nerve diseases, diabetes mellitus