Gumanova NG, Vasilyev DK, Mols AAA, Drapkina OM, Kiselev AR. Femoral artery plaque: A simple ultrasound clue for severe coronary stenosis. World J Cardiol 2025; 17(11): 110899 [DOI: 10.4330/wjc.v17.i11.110899]
Corresponding Author of This Article
Anton R Kiselev, Head, Professor, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, Str. 3, Moscow 101990, Russia. antonkis@list.ru
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Nov 26, 2025; 17(11): 110899 Published online Nov 26, 2025. doi: 10.4330/wjc.v17.i11.110899
Femoral artery plaque: A simple ultrasound clue for severe coronary stenosis
Nadezhda G Gumanova, Dmitry K Vasilyev, Alexandre A A Mols, Oxana M Drapkina, Anton R Kiselev
Nadezhda G Gumanova, Alexandre A A Mols, Anton R Kiselev, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow 101990, Russia
Dmitry K Vasilyev, Department of Cardiovascular X-ray Surgery, National Medical Research Center for Therapy and Preventive Medicine, Moscow 101990, Russia
Oxana M Drapkina, Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, Moscow 101990, Russia
Co-first authors: Nadezhda G Gumanova and Dmitry K Vasilyev.
Author contributions: Gumanova NG presented the creative process, investigation process and published works; Gumanova NG and Vasilyev DK they contributed equally to this article, they are the co-first authors of this manuscript; Vasilyev DK and Mols AAA were used to guide patients, collect data, conduct research and investigation processes; Drapkina OM and Kiselev AR managed and proofread; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of National Medical Research Center for Therapy and Preventive Medicine, approval No. 01-01/17.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data presented in this study are available on request from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anton R Kiselev, Head, Professor, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, Str. 3, Moscow 101990, Russia. antonkis@list.ru
Received: June 18, 2025 Revised: July 7, 2025 Accepted: October 24, 2025 Published online: November 26, 2025 Processing time: 156 Days and 14.6 Hours
Abstract
BACKGROUND
With rising angiography costs and risks, we explored whether a 5-minute femoral ultrasound can predict patients that actually require angiography.
AIM
To detect associations between atherosclerosis of peripheral arteries and coronary stenosis in patients with coronary heart disease (CHD).
METHODS
The study included a total of 218 patients (63 ± 10.9 years of age; 54% male) with CHD subjected to coronary angiography and routine diagnostic assessment, including ultrasound imaging to assess the extent of peripheral atherosclerotic lesions. Receiver operating characteristic analysis and binomial logistic regression were used to detect the associations.
RESULTS
We demonstrated for the first time that the presence of atherosclerotic plaque with ≥ 70% stenosis in femoral arteries was associated with significant coronary stenosis, with 93% sensitivity and 90% specificity, and thus can be used as an additional diagnostic marker for coronary stenosis. The data indicated associations between femoral artery atherosclerosis and atherosclerotic lesions of coronary arteries, with a high correlation coefficient r = 0.8 (P < 0.05). The presence of an atherosclerotic plaque in the femoral arteries with ≥ 30% or ≥ 70% stenosis was associated with a 30- or 70-fold higher odds ratio of coronary stenosis, respectively.
CONCLUSION
For resource-limited clinics, our findings suggest skipping carotids - femoral ultrasound alone may suffice to rule out severe CHD. Ultrasound imaging femoral artery atherosclerosis provides a simplified approach for patient stratification.
Core Tip: With rising angiography costs and risks, we explored whether a 5-minute femoral ultrasound could predict who truly needs it. We have analyzed associations between atherosclerosis of peripheral arteries detected by ultrasound and coronary stenosis detected by angiography with evaluation of the extent of coronary lesions using the Gensini score. A femoral plaque ≥ 70% flagged severe coronary stenosis as reliably as many blood tests (area under curve 0.93 with 93% sensitivity and 90% specificity), like troponin for myocardial infarction.
