Первая международная удаленная научно-практическая конференция

"Сердечно-сосудистая хирургия и ангиология - 2003"

First International Scientific Teleconference

"Cardiovascular Surgery and Angiology - 2003"

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Z. Rancic, Dj.Radak, M.Stojiljkovic, M. Radojkovic, D. Rancic

Limited carotid screening: IS IT INDICATED TO DETECT CAROTID DISEASE IN PRESENCE OF SYMPTOMATIC LIMB ISCHEMIA ?

Surgical Clinic Clinical Center Nis, Nis

Institute for Cardiovascular Disease “Dedinje”

Belgrade, Yugoslavia

Summary: A complete and thorough initial angiologic examination in patients with symptomatic arterial occlusive disease should include discovery of a previously undetected carotid bruit.

The aim of our study was to establish characteristics of asymptomatic carotid bruit based on physical examination and color-flow duplex scanning. We screened asymptomatic carotid artery disease in 109 patients with symptomatic peripheral vascular disease treated at University Surgical Clinic in Nis, and Institute for Cardiovascular Disease ”Dedinje” in Belgrade.

Of 109 patients with no symptoms or signs of carotid occlusive disease, carotid bruit was present in 57 (52%); 17 were unilateral, (10 right and 6 left) and 40 were bilateral. The majority of the patients 27 (47%) were present with moderate to rough bilateral bruit.

All patients were studied with color-Doppler duplex scanning according to criterion of ACAS. Bilateral haemodynamically significant carotid artery stenosis (CAS) ≥ 60% was present in 18 (32%) patients, unilateral in 17 (30%) and in 22 patients (38%) asymptomatic carotid bruit was not originated from CAS ≥ 60%.

By univariate analysis significant CAS was associated with carotid bruit (results were considered significant if p<0,05). Probability that CAS ≥ 60% influenced the prevalence of asymptomatic carotid bruit, assessed by multivariate stepwise logistic regression analysis, was confirmed (t=0,50; p=0,01). The sensitivity of a carotid bruit in predicting CAS ≥ 60% was 67%, with a specificity of 56%. Degree of internal carotid stenosis was unrelated to plaque morphology.

Limiting screening of haemodynamically significant carotid artery stenosis to subgroups of patients with asymptomatic carotid bruit is ineffective, because more than one third of patients with CAS would be excluded in that way.

Keywords: a asymptomatic carotid artery stenosis, carotid bruit, peripheral vascular disease, screening.

 Rancic Z., Radak Dj., Stojiljkovic M.et al. Limited carotid screening: IS IT INDICATED TO DETECT CAROTID DISEASE IN PRESENCE OF SYMPTOMATIC LIMB ISCHEMIA ? // The First International Scientific Teleconference "Cardiovascular Surgery and Angiology - 2003", The book of Conference.- SPb, 2003.- P.