Atherosklerose-Screening der karotidalen und peripheren Arterien

Background Atherosclerotic diseases, such as peripheral arterial occlusive disease (PAOD) and stenosis of the internal carotid artery (ICA) are a global health problem. Due to the progressive character, symptoms appear only after the formation of larger calcium plaques in the arterial wall; however, early detection measures could prevent late complications, such as amputation and stroke even in asymptomatic patients.Objective This article presents international and national guideline recommendations on the indications and methodology of PAOD and ICA stenosis screening, highlights corresponding points of criticism and discusses alternatives to screening and the screening procedure.Material and methodsA literature search was carried out in the PubMed database and in the latest international and national guidelines on PAOD and ICA stenosis.ResultsThe PAOD screening and mass screening for ICA stenosis are not recommended due to lack of evidence and the unfavorable benefit-risk ratio. In the presence of multiple cardiovascular risk factors, such as age >65 years and smoking history, ICA stenosis screening should be performed by color-coded duplex sonography using the criteria of the North American symptomatic carotid endarterectomy trial. In specific situations, especially preoperatively, cardiovascular comorbidities should be excluded due to the underlying systemic disease.Conclusion Current epidemiological and interventional studies will influence future screening recommendations. Also, methods for earlier atherosclerosis detection, such as risk scores and intima media thickness as well as approaches for drug treatment of all risk patients without prior diagnostics could then play a greater role