Stratégie de la conduite des examens chez le patient polyvasculaire

The prevalence of cardiovascular diseases increases with age. Population aging induces an increasing number of revascularisation procedures (surgical or endovascular) among patients often presenting with multiple localisations of atherosclerotic disease. Since atherosclerosis is a diffuse process, a patient with an ischemic disease located in one territory has also, frequently, other asymptomatic localisations in other arterial territories. For example, we estimated that almost 50 to 70 % of late mortality after carotid surgery is mainly due to a coronary disease misdiagnosed at the time of pre operative assessment. Furthermore we know that among these patients 11 % have an associated aortic abdominal aneurysm when the actual incidence in the general population is 2 %. It is therefore of primary importance to consider this frequency of associated lesions in order to optimize the appropriate choice of imaging investigations.