Prevalence of plaques and stenoses detectable by echo-Doppler examination in the femoral arteries of an elderly population

Using echo-Doppler evaluation, we assessed the prevalence of possible atherosclerotic lesions in the common femoral arteries ( n = 478) and superficial femoral arteries ( n = 478) in 239 subjects (age range 65–94 years) living in retirement houses in Seattle. Ankle pressure was measured with a pneumatic cuff and a continuous wave Doppler. There were 68 individuals with an ankle arm index less than 0.97 and 39 of these with a index below 0.90. An echo-Doppler examination was performed with an Advanced Technologies Laboratories Mark 600 Duplex Scanner. We found 167 (34.9%) common femoral arteries affected by non-stenosing plaque while 19 arteries (4%0) had stenosis or occlusion. In addition, 178 (37.2%) superficial femoral arteries showed non-stenosing plaques. The subjects with common femoral disease were 27 (11.3%), those with evidence of superficial femoral artery disease were 48 (20.1%), and those affected by disease in both sites were 84 (35.1%). There were 80 people (33.5%) with no ultrasound evidence of femoral artery disease. We found that the presence and severity of disease increased progressively in the decades 65–74, 75–84 and 85–94. We also demonstrated a positive association between major cardiovascular risk factors and ultrasound evidence of peripheral disease. The prevalence of femoral artery disease in an apparently healthy population was relatively high, although stenoses in most instances were not severe. We conclude that non-invasive ultrasound methods identify a fraction of individuals ( n = 39, 16% of the total) with flow-reducing stenoses (ankle-arm index (AAI) < 0.90) in the peripheral circulation of the lower limbs: they are expected to be at high risk for cardiovascular death in general. Echo-Doppler might be used to monitor further disease progression and to evaluate the efficacy of different therapeutic or preventive interventions.