Stroke, Vol 12, 750-758, Copyright © 1981 by American Heart Association
M Hennerici, A Aulich, W Sandmann and HJ Freund
Investigations of the incidence and the extent of the asymptomatic early
stages of extracranial arterial disease (EAD) have been restricted for
methodical reasons. Direct Continuous Wave-Doppler examination has given
highly accurate results in the location and correct estimation of the
degree of EAD both for the carotid (97%) and the vertebral arteries (90%),
as shown from a detailed comparison with carotid (n = 604) and vertebral (n
= 426) angiograms. Compared with this degree of reliability, the validity
of normal auscultation for the diagnosis of EAD is shown to be poor: if
bruits are taken as the only signs of associated EAD in patients with
systemic atherosclerosis, only 27.6% in a group of 123 patients would have
been correctly diagnosed. This parallels the number of false-positives
(22.6%) in patients with normal results. The frequency and degree of EAD
was studied by the use of direct Doppler examination in 2009 neurologically
asymptomatic patients admitted either with severe vascular (n = 375) or
coronary atherosclerosis (n = 262) or with high-risk factors (n = 1370).
The frequency was significantly higher (32.8%) in patients with peripheral
vascular disease than in those with coronary artery disease (6.8%) and in
risk-factor patients (5.9%). The combination and degree of vessel
involvement are presented in detail and their possible prognostic
significance discussed.
ARTICLES
Incidence of asymptomatic extracranial arterial disease
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