Avaliação da doença carotídea em pacientes com doença arterial periférica

Abstract

Objective: To study stenosis in carotid arteries in patients with symptomatic peripheral arterial disease. Methods: The present study consecutively evaluated 100 patients with symptomatic peripheral arterial disease at stages of intermittent claudication, rest pain or trophic lesions. Carotid atherosclerosis was studied by means of an echo-color-doppler and was considered significant when levels of greater than or equal to 50% had been reached. The univariate analysis was used to select the potential predictors of carotid stenosis, which were later submitted to multivariate analyses. Results: The prevalence of carotid atherosclerosis was 84%, with significant stenosis in 40% and critical stenosis in 17%. Patient ages ranged from 43 to 89 years of age (average of 69.78 years). Regarding gender, 61% of the patients were male and 39% female. Half of the patients presented with claudication, while the other half had critical limb ischemia. Concerning the risk factors, 86% of the patients had systemic arterial hypertension, 66% exposure to smoking, 47% diabetes, 65% dyslipidemia, 24% coronary artery disease, 16% renal insufficiency and 60% a positive family medical history of cardiovascular diseases. Seven patients reported some form of cerebrovascular symptoms in the carotid region. The presence of cerebrovascular symptoms proved to be statistically significant in influencing the degree of stenosis in the carotid arteries. Conclusions: Patients with symptomatic peripheral arterial disease presented high prevalence of significant Carotid Stenosis (40%). Prior history of neurological symptoms was found to be statistically significant in explaining the severity of carotid stenosis.