Carotid and imaging (ICVTS only)
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Occult carotid artery disease in patients who have undergone coronary angioplasty
Nicholas Fassiadis 1,
Kate Adams 1*,
Hany Zayed 1,
David Goss 1,
Colin Deane 1,
Philip MacCarthy 1,
Hisham Rashid 1
1 Kings College Hospital NHS Trust, London, UK
* To whom correspondence should be addressed. E-mail: kate1moss{at}hotmail.com.
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Abstract |
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Objectives: 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. Keywords: Carotid artery stenosis; Coronary angioplasty; Screening
