The relationship between symptomatic lower extremity peripheral artery disease with carotid artery stenosis and ischemic stroke

Hasan Hüseyin Kır, Mehmet Işık, Ömer Tanyeli, Mukaddes Rüveydaoğlu Ceran, Ali Vasfi Ağlarcı, Muhammet Talha Ceran, Hasan Hüseyin Kozak

Abstract

Objective: The aim of this study was to investigate the prevalence of carotid artery stenosis (CAS) in peripheral artery disease (PAD) patients requiring surgical or interventional procedures, to examine the clinical relationship between CAS and PAD, and to determine the characteristics of ischemic stroke developing within a one-year postoperative period.
Methods: Between August 2020 and January 2024, Doppler ultrasonography was performed to image the carotid arteries in patients diagnosed with PAD who underwent interventional procedures or surgical operations (Fontaine classification stage 2B and above). A total of 108 patients who continued follow-up were prospectively monitored for cerebrovascular events for 1 year.
Results: A near-significant association was observed between claudication distance and history of stroke (p = 0.08). Another near-significant association was found between claudication distance and National Institutes of Health Stroke Scale (NIHS) scores in patients who had a stroke (p = 0.07). A positive correlation (p < 0.01) was found between a history of stroke with severe CAS and NIHSS scores.
Conclusions: In our study, we found that the prevalence of CAS was higher in PAD patients compared to the general population, and that they had a significant risk of cerebrovascular events during follow-up. Our study supports other studies recommending routine carotid ultrasound in patients diagnosed with PAD. The use of simple clinical measures such as claudication distance in cerebrovascular risk assessment may be beneficial in developing early diagnosis and treatment strategies in clinical practice.