Korean Circ J.  2013 Aug;43(8):550-556. 10.4070/kcj.2013.43.8.550.

Coexistence of Internal Carotid Artery Stenosis in Patients with Abdominal Aortic Aneurysm

Affiliations
  • 1Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia. vranesmilica@gmail.com
  • 2Medical Faculty, University of Belgrade, Belgrade, Serbia.

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 > or =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 > or =70% in patients with AAA is 10.8%. Male representatives have more symptomatic ICA stenosis > or =70%. Patients with small aneurysms more often have asymptomatic ICA stenosis > or =70%. The occurrence of symptoms of carotid disease was more prevalent among patients with ICA stenosis > or =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 > or =70% in patients with AAA is found to be 10.8%. Male patients with ICA stenosis > or =70% more often had symptoms of carotid disease. In the smaller aneurysms, ICA stenosis > or =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.

Keyword

Prevalence; Signs and Symptoms; Internal carotid artery stenosis; Aortic aneurysm, abdominal

MeSH Terms

Aged
Aneurysm
Aortic Aneurysm, Abdominal
Carotid Artery, Internal
Carotid Stenosis
Constriction, Pathologic
Humans
Male
Prevalence
Prospective Studies
Serbia

Reference

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; 64:405–408. PMID: 14894065.
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; 97:257–266. PMID: 13090050.
4. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg. 1991; 5:491–499. PMID: 1837729.
5. Wilmink TB, Quick CR, Day NE. The association between cigarette smoking and abdominal aortic aneurysms. J Vasc Surg. 1999; 30:1099–1105. PMID: 10587395.
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. PMID: 12433761.
7. Lederle FA, Johnson GR, Wilson SE. Aneurysm Detection and Management Veterans Affairs Cooperative Study. Abdominal aortic aneurysm in women. J Vasc Surg. 2001; 34:122–126. PMID: 11436084.
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; 38:748–749. PMID: 19666232.
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; 23:213–220. discussion 221-2. PMID: 8637098.
10. Fisher M. Occlusion of the internal carotid artery. AMA Arch Neurol Psychiatry. 1951; 65:346–377.
11. Clinical advisory: carotid endarterectomy for patients with asymptomatic internal carotid artery stenosis. Stroke. 1994; 25:2523–2524. PMID: 7974602.
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; 126:337–346. PMID: 9054277.
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; 21:984–988. PMID: 2368113.
14. Strully KJ, Hurwitt ES, Blankenberg HW. Thrombo-endarterectomy for thrombosis of the internal carotid artery in the neck. J Neurosurg. 1953; 10:474–482. PMID: 13097208.
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. PMID: 13637687.
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; 358:1617–1621. PMID: 18403770.
18. Risk of stroke in the distribution of an asymptomatic carotid artery. The European Carotid Surgery Trialists Collaborative Group. Lancet. 1995; 345:209–212. PMID: 7823712.
19. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA. 1995; 273:1421–1428. PMID: 7723155.
20. Fayad P. Endarterectomy and stenting for asymptomatic carotid stenosis: a race at breakneck speed. Stroke. 2007; 38(2 Suppl):707–714. PMID: 17261722.
21. Norris JW, Zhu CZ, Bornstein NM, Chambers BR. Vascular risks of asymptomatic carotid stenosis. Stroke. 1991; 22:1485–1490. PMID: 1962321.
22. Chambers BR, Norris JW. The case against surgery for asymptomatic carotid stenosis. Stroke. 1984; 15:964–967. PMID: 6506125.
23. Goessens BM, Visseren FL, Kappelle LJ, Algra A, van der. Asymptomatic carotid artery stenosis and the risk of new vascular events in patients with manifest arterial disease: the SMART study. Stroke. 2007; 38:1470–1475. PMID: 17363718.
24. Willeit J, Kiechl S. Prevalence and risk factors of asymptomatic extracranial carotid artery atherosclerosis. A population-based study. Arterioscler Thromb. 1993; 13:661–668. PMID: 8485116.
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; 23:1752–1760. PMID: 1448826.
26. Pujia A, Rubba P, Spencer MP. Prevalence of extracranial carotid artery disease detectable by echo-Doppler in an elderly population. Stroke. 1992; 23:818–822. PMID: 1595098.
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; 16:963–970. PMID: 8696960.
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; 126:687–691. discussion 691-2. PMID: 10520916.
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. PMID: 11791030.
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; 38:1220–1225. PMID: 14681618.
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