ASYMPTOMATIC CAROTID-ARTERY BIFURCATION DISEASE IN PATIENTS WITH CLAUDICATION

A study was undertaken to determine the prevalence of asymptomatic ath erosclerotic carotid artery bifurcation disease in patients presenting with claudication; thus 263 consecutive patients with intermittent cl audication, but without recent or old cerebrovascular symptoms were st udied by routine carotid duplex scanning. Of the 263 patients, 124 (47 ,1%) had a C, D, D+ or E lesion in some vessels of the carotid bifurca tion and 54 (20,5%) had a D, D+ or E lesion of the common or internal carotid arteries. Women had a higher prevalence of significant carotid stenosis (29,6% v. 18,2% in men) as did patients over the age of 70 y ears (28,6% v. 16,3% if below 70 years). It is concluded that the prev alence of clinically significant carotid bifurcation disease (greater than 50% stenosis in the common or internal carotid arteries) in patie nts with claudication is high (20,5%). The presence of an asymptomatic high-grade stenosis (D+ or E) in 11,8% of patients with claudication should alert the clinician that he is treating a patient who is at a h igh risk of developing cerebrovascular ischaemic complications.