Objectives: To determine the prevalence of asymptomatic carotid artery stenosis (ACAS) in patients with peripheral vascular disease (PVD).
Methods: Literature search was carried out through Pubmed, Medline and Cochrane library. Prospective studies published on prevalence of significant carotid stenosis in patients with PVD and used a duplex scan for screenings were included.
Results: Nineteen studies with a total of 4573 patients were included. A prevalence of 28% (fixed effect model) and 25% (random effect model) was seen for >50% stenosis, and 14% (in both fixed and random effect models) for 70% stenosis. Significant statistical heterogeneity existed between studies (I(2)=82.7%, >50% group) (I(2)=77.5%, >70% group). Larger studies revealed a higher prevalence of carotid stenosis.
Conclusion: High prevalence of ACAS exists in patients with PVD. A large multi centre prospective study may help to combat heterogeneity and identify subgroups of PVD patients with higher prevalence. Clinicians who believe in the benefits of carotid endarterectomy for asymptomatic carotid stenosis would gain a greater yield by targeting this group for routine screening rather than a healthy population.
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http://dx.doi.org/10.1016/j.ejvs.2008.10.017 | DOI Listing |
Carotid artery atherosclerotic stenosis is an important annual cause of stroke in the United States. Moreover, the incidence of carotid artery stenosis is significantly increasing due to the widespread popularity of high fat and high salt diets, sedentary lifestyles, and the increasing age of the population. Of major importance to cardiovascular specialists is the fact that individuals with atherosclerotic carotid artery stenosis can have a prevalence of atherosclerotic coronary artery disease as high as 50 to 75%.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Background: Carotid webs are rare nonatherosclerotic disorders in the carotid artery and are increasingly recognized as factors of ischemic stroke in the young population. Asymptomatic webs can be treated with antithrombotic therapy, whereas symptomatic cases frequently require surgical interventions, including carotid endarterectomy (CEA). However, guidelines for the optimal timing of these treatments remain unestablished, especially compared to atherosclerotic stenotic lesions, due to the rarity of carotid webs.
View Article and Find Full Text PDFOrbit
January 2025
Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
Purpose: Carotid-cavernous fistulas (CCFs) are treated almost exclusively by endovascular techniques, but the frequency of treatments is limited in smaller centers. We analyzed all CCFs treated in our hospital to determine if high-quality treatment of CCFs can be provided in a medium-volume neurovascular center.
Methods: Retrospective quality-control cohort study.
Br J Hosp Med (Lond)
December 2024
Department of Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Ischemic stroke (IS), a cerebrovascular condition, is commonly detected by evaluating carotid intima-media (CIA) stenosis. Symptomatic CIA stenosis carries a high risk (up to 32%) of another ischemic event within 12 weeks, while asymptomatic CIA stenosis has an annual risk ranging from 1% to 2%. Therefore, this study aims to explore the diagnostic value of clinical features and carotid plaque characteristics in both symptomatic and asymptomatic IS.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
Department of Vascular Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021, China.
Extracranial carotid artery aneurysm (ECAA) is a relatively rare vascular lesion of the neck, and is usually found incidentally and is usually asymptomatic. Surgery is currently the first choice for symptomatic or growing ECAA, including open resection of the entire aneurysm, with or without arterial replacement and insertion of grafts. Ischemic stroke is the most serious complication after resection of ECAA.
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