Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Coexistence of Internal Carotid Artery Stenosis in Patients with Abdominal Aortic Aneurysm

  • Vranes, Milica (Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia) ;
  • Davidovic, Lazer (Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia) ;
  • Vasic, Dragan (Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia) ;
  • Radmili, Oliver (Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia)
  • Published : 2013.08.30
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Abstract

Background and Objectives: Abdominal Aortic Aneurysm (AAA) and carotid disease have medical and social significance, considering their morbidity, disability, and economic consequences. The study objectives were to determine the prevalence of asymptomatic internal carotid artery (ICA) lesions ${\geq}70%$ in patients with AAA, the correlation of AAA diameter with the degree of ICA stenosis and symptoms, and the importance of preventive ultrasound checkups. Subjects and Methods: A prospective non-randomized controlled study including 740 patients, aged from 18-85 years, who were suitable for the inclusion and exclusion criteria and reported at the vascular laboratory of the Institute for Vascular and Endovascular Surgery, Clinical Center of Serbia from 1st of December 2011 to the 1st of November 2012. Results: The prevalence of asymptomatic ICA stenosis ${\geq}70%$ in patients with AAA is 10.8%. Male representatives have more symptomatic ICA stenosis ${\geq}70%$. Patients with small aneurysms more often have asymptomatic ICA stenosis ${\geq}70%$. The occurrence of symptoms of carotid disease was more prevalent among patients with ICA stenosis ${\geq}70%$ compared to the group with stenosis <70%. There was no correlation found between the grade of ICA stenosis with the size of AAA. Conclusion: The prevalence of asymptomatic ICA stenosis ${\geq}70%$ in patients with AAA is found to be 10.8%. Male patients with ICA stenosis ${\geq}70%$ more often had symptoms of carotid disease. In the smaller aneurysms, ICA stenosis ${\geq}70%$ occurs frequently, but without the symptoms of carotid disease, and there was no correlation between the size of AAA and the grade of ICA stenosis. Clinical implications of ICA imaging in patients with previously diagnosed AAA is necessary.

Keywords

References

  1. Leonardo RA. History of Surgery. New York: Froben Press;1943.
  2. Dubost C, Allary M, Oeconomos N. Resection of an aneurysm of the abdominal aorta: reestablishment of the continuity by a preserved human arterial graft, with result after five months. AMA Arch Surg 1952;64:405-8. https://doi.org/10.1001/archsurg.1952.01260010419018
  3. De Bakey ME, Cooley DA. Surgical treatment of aneurysm of abdominal aorta by resection and restoration of continuity with homograft. Surg Gynecol Obstet 1953;97:257-66.
  4. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991;5:491-9. https://doi.org/10.1007/BF02015271
  5. Wilmink TB, Quick CR, Day NE. The association between cigarette smoking and abdominal aortic aneurysms. J Vasc Surg 1999;30:1099-105. https://doi.org/10.1016/S0741-5214(99)70049-2
  6. Multicentre Aneurysm Screening Study Group. Multicentre aneurysm screening study (MASS): cost effectiveness analysis of screening for abdominal aortic aneurysms based on four year results from randomised controlled trial. BMJ 2002;325:1135. https://doi.org/10.1136/bmj.325.7373.1135
  7. Lederle FA, Johnson GR, Wilson SE; Aneurysm Detection and Management Veterans Affairs Cooperative Study. Abdominal aortic aneurysm in women. J Vasc Surg 2001;34:122-6. https://doi.org/10.1067/mva.2001.115275
  8. Salem MK, Rayt HS, Hussey G, et al. Should Asian men be included in abdominal aortic aneurysm screening programmes? Eur J Vasc Endovasc Surg 2009;38:748-9. https://doi.org/10.1016/j.ejvs.2009.07.012
  9. Brown PM, Pattenden R, Vernooy C, Zelt DT, Gutelius JR. Selective management of abdominal aortic aneurysms in a prospective measurement program. J Vasc Surg 1996;23:213-20; discussion 221-2. https://doi.org/10.1016/S0741-5214(96)70265-3
  10. Fisher M. Occlusion of the internal carotid artery. AMA Arch Neurol Psychiatry 1951;65:346-77. https://doi.org/10.1001/archneurpsyc.1951.02320030083009
  11. Clinical advisory: carotid endarterectomy for patients with asymptomatic internal carotid artery stenosis. Stroke 1994;25:2523-4. https://doi.org/10.1161/01.STR.25.12.2523
  12. Lee TT, Solomon NA, Heidenreich PA, Oehlert J, Garber AM. Cost-effectiveness of screening for carotid stenosis in asymptomatic persons. Ann Intern Med 1997;126:337-46. https://doi.org/10.7326/0003-4819-126-5-199703010-00001
  13. Wiebers DO, Whisnant JP, Sandok BA, O'Fallon WM. Prospective comparison of a cohort with asymptomatic carotid bruit and a populationbased cohort without carotid bruit. Stroke 1990;21:984-8. https://doi.org/10.1161/01.STR.21.7.984
  14. Strully KJ, Hurwitt ES, Blankenberg HW. Thrombo-endarterectomy for thrombosis of the internal carotid artery in the neck. J Neurosurg 1953;10:474-82. https://doi.org/10.3171/jns.1953.10.5.0474
  15. De Bakey ME, Crawford ES, Cooley DA, Morris GC Jr. Surgical considerations of occlusive disease of innominate, carotid, subclavian, and vertebral arteries. Ann Surg 1959;149:690-710. https://doi.org/10.1097/00000658-195905000-00010
  16. Zwibel WJ, Pellerito JS. Introduction to vascular ultrasonography. 5th ed. Philadelphia: Elsevier Saunders;2004. p.272.
  17. Sila CA, Higashida RT, Clagett GP. Clinical decisions. Management of carotid stenosis. N Engl J Med 2008;358:1617-21. https://doi.org/10.1056/NEJMclde0800741
  18. Risk of stroke in the distribution of an asymptomatic carotid artery. The European Carotid Surgery Trialists Collaborative Group. Lancet 1995;345:209-12. https://doi.org/10.1016/S0140-6736(95)90220-1
  19. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA 1995;273:1421-8. https://doi.org/10.1001/jama.1995.03520420037035
  20. Fayad P. Endarterectomy and stenting for asymptomatic carotid stenosis: a race at breakneck speed. Stroke 2007;38(2 Suppl):707-14. https://doi.org/10.1161/01.STR.0000250047.01624.fd
  21. Norris JW, Zhu CZ, Bornstein NM, Chambers BR. Vascular risks of asymptomatic carotid stenosis. Stroke 1991;22:1485-90. https://doi.org/10.1161/01.STR.22.12.1485
  22. Chambers BR, Norris JW. The case against surgery for asymptomatic carotid stenosis. Stroke 1984;15:964-7. https://doi.org/10.1161/01.STR.15.6.964
  23. Goessens BM, Visseren FL, Kappelle LJ, Algra A, van der Graaf Y. Asymptomatic carotid artery stenosis and the risk of new vascular events in patients with manifest arterial disease: the SMART study. Stroke 2007;38:1470-5. https://doi.org/10.1161/STROKEAHA.106.477091
  24. Willeit J, Kiechl S. Prevalence and risk factors of asymptomatic extracranial carotid artery atherosclerosis. A population-based study. Arterioscler Thromb 1993;13:661-8. https://doi.org/10.1161/01.ATV.13.5.661
  25. O'Leary DH, Polak JF, Kronmal RA, et al. Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study. The CHS Collaborative Research Group. Stroke 1992;23:1752-60. https://doi.org/10.1161/01.STR.23.12.1752
  26. Pujia A, Rubba P, Spencer MP. Prevalence of extracranial carotid artery disease detectable by echo-Doppler in an elderly population. Stroke 1992;23:818-22. https://doi.org/10.1161/01.STR.23.6.818
  27. Alcorn HG, Wolfson SK Jr, Sutton-Tyrrell K, Kuller LH, O'Leary D. Risk factors for abdominal aortic aneurysms in older adults enrolled in The Cardiovascular Health Study. Arterioscler Thromb Vasc Biol 1996;16:963-70. https://doi.org/10.1161/01.ATV.16.8.963
  28. Kang SS, Littooy FN, Gupta SR, et al. Higher prevalence of abdominal aortic aneurysms in patients with carotid stenosis but without diabetes. Surgery 1999;126:687-91; discussion 691-2. https://doi.org/10.1016/S0039-6060(99)70123-6
  29. Zureik M, Temmar M, Adamopoulos C, et al. Carotid plaques, but not common carotid intima-media thickness, are independently associated with aortic stiffness. J Hypertens 2002;20:85-93. https://doi.org/10.1097/00004872-200201000-00013
  30. Liapis CD, Kakisis JD, Dimitroulis DA, Daskalopoulos M, Nikolaou A, Kostakis AG. Carotid ultrasound findings as a predictor of long-term survival after abdominal aortic aneurysm repair: a 14-year prospective study. J Vasc Surg 2003;38:1220-5. https://doi.org/10.1016/S0741-5214(03)00716-X

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