ORIGINAL ARTICLES   

Chirurgia 2013 August;26(4):291-4

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Carotid screening with Duplex ultrasound in elderly asymptomatic patients candidate to general surgery

Compagna R. ¹, Vigliotti G. ¹, Rispoli C. ², Rocco N. ¹, Iannone L. ¹, Testa S. ¹, Salvati V. ¹, Donisi M. ¹, Sivero L. ¹, Amato B. ¹

¹ Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Federico II University, Naples, Italy; ² Department of General and Emergency Surgery, ASL Napoli1 Centro, Naples, Italy

Aim: Asymptomatic internal carotid artery steno-occlusion can be identified in different ways: the presence of a carotid bruit on physical examination, an asymptomatic stenosis contralateral to a symptomatic lesion and the presence of risk factors for atherosclerosis. The preferred screening test for hemodynamically significant stenosis of the internal carotid artery is the echo-color-Doppler.
Methods: We studied with carotid echo-color-Doppler 252 asymptomatic patients candidate for general surgery, with a mean age of 66 years.
Results: The results indicated that it was detected the presence of stenosis >70% in 25% of cases, moderate stenoses ranging from 30-69% in 70% of cases and complete thrombosis in 5% of cases. The multivariate statistical analysis of the data showed that age, cigarette smoking and the presence of carotid bruit are independent risk factors for carotid stenosis hemodynamically significant, while there is no association between hemodynamically significant stenosis of the internal carotid and the concomitant surgical pathology. In addition there was no correlation between hypertension, diabetes, chronic coronary syndrome, weight and dyslipidemia with the presence of severe asymptomatic carotid stenosis.
Conclusion: In conclusion, we recommend the routine use of echo-color-doppler carotid artery survey in elderly patients and smokers, candidates for general surgery.