Prevalence of atherosclerotic lesions at the carotid bifurcation in patients with asymptomatic bruits: an echo-Doppler (duplex) study.

The prevalence of atherosclerotic lesions at the carotid bifurcation with asymptomatic Meck bruits has been evaluated in 71 patients, 42 males, ages ranging from 19 to 84 yrs, referred to our non-invasive vascular laboratory for an echo-Doppler (duplex) scan, associated with spectral analysis (Mark V ATL with Flow analyzer 459). Fifty-nine patients had mid-neck or high-neck bruits (30 bilateral), 12 had low-neck bruits (4 bilateral). The internal carotid arteries were classified as normal, minimal stenosis (diameter reduction 20%), moderate stenosis (20-49%), severe stenosis greater than or equal to 50%), total occlusion. Twenty-four of the internal carotid arteries homolateral to a mid- or high-neck bruit were normal, 84% had stenosis of various degree (16% severe), 2% were occluded. Stenoses of various degree were also present on the contralateral side of the bruit. No lesions above a diameter reduction of 20% were present in the internal carotid arteries corresponding to a low-neck bruit. The echo-Doppler (duplex) system, being capable of spanning the whole spectrum of the internal carotid occlusive disease, allows us to limit the number of the invasive diagnostic procedures in asymptomatic patients.