SHOULD DOPPLER ULTRASOUND DETECTION OF EX TRACARDIAC ATHEROSCLEROSIS BE PERFORMED SYSTEMATICALLY IN ALL PATIENTS WITH CORONARY HEART-DISEASE - REPORT OF A SERIES OF 248 CASES

Doppler ultrasound investigation of cervical and aorto-iliac arteries, performed in 248 patients investigated by coronary angiography (inclu ding 80 % with coronary heart disease: 23 % single-vessel, 23 % two-ve ssel and 34 % three-vessel disease) confirmed the frequency of dissemi nation of the atheromatous process (in the cervical vessels: non-steno tic atheroma : 45 %, significant single- or multi-vessel stenoses: 16 %, in the aorto-iliac vessels: non-stenotic atheroma: 32.8 %, signific ant stenoses, 17.2 %), which has been known for a long time. The unrel iability of clinical examination, the reliability, safety and low cost of ultrasound, the discovery of a considerable number of critical, po tentially dangerous arterial lesions, some of which may require a surg ical procedure or angioplasty (3.4 %), the value of assessing, either before coronary angiography or before cardiac surgery, certain specifi c arterial territories such as the aortic bifurcation and subclavian v essels, justify systematic use of this examination in coronary patient s, particularly before coronary angiography and always before coronary surgery.