During the 5-year follow-up period, 183 patients had a stroke. In patients with PAD (n = 1429) compared to those without PAD (n = 5392), the incidence of all stroke types, with the exception of hemorrhagic stroke, was about doubled (for fatal stroke tripled). The corresponding adjusted hazard ratios were 1.6 (95% CI 1.1–2.2) for total stroke, 1.7 (95% CI 1.2–2.5) for ischemic stroke, 0.7 (95%

CI 0.2–2.2) for hemorrhagic stroke, selleckchem 2.5 (95% CI 1.2–5.2) for fatal stroke and 1.4 (95% CI 0.9–2.1) for nonfatal stroke. Lower ABI categories were associated with higher stroke rates. Besides high age, previous stroke and diabetes mellitus, PAD was a significant independent predictor for ischemic stroke. The stroke risk was similar in patients with symptomatic

(n = 593) as compared to asymptomatic (n = 836) PAD. Interestingly, recent studies that analyzed the prognostic impact of low ABI values (<0.9) on stroke recurrence and cardiovascular events in acute stroke patients revealed comparable results (Fig. 1). Purroy et al. [17] observed an increased stroke recurrence rate (32.1 vs. 13.6%, p < 0.001) and more vascular events (50 vs. 70%, p < 0.001) in patients with low ABI values. Similar results were seen in the SCALA trial [18] that examined 852 patients from 85 neurological stroke units throughout Germany as well as the PATHOS study [19] from Italy with 755 acute stroke patients. Busch et al. [20] described an increased risk for CHIR-99021 supplier stroke, myocardial infarction or death in acute stroke patients with a low ABI < 0.9 (relative risk 2.2; 95% CI 1.1–4.5). An ABI < 0.9 is an independent predictor of stroke recurrence in acute stroke. "
“In 1986, Decitabine the first German guideline for measuring the degree of carotid stenosis with sonography based on an intersociety consensus was published

[15]. At that time, continuous wave (CW) Doppler sonographic was the prevailing methodology. As part of duplex sonography B-Mode imaging was added as rather poor method for correcting the orientation of the Doppler beam and placement of the sample volume. CW Doppler criteria for estimating the degree of narrowing were mainly based on hemodynamic parameters. Later duplex criteria were established in accordance with the established CW Doppler sonographic criteria. The stenotic signal was categorised using descriptive terms and broad Doppler shift categories. In North America, documentation through imaging is of special importance because of the division of duties between technician (examining) and physician (reading). Soon duplex sonography replaced C-Mode Doppler imaging and the simple “Doppler ophthalmic test” as one of the hemodynamic parameters became unpopular.