Walsh D B, Gilbertson J J, Zwolak R M, Besso S, Edelman G C, Schneider J R, Cronenwett J L
Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756.
J Vasc Surg. 1991 Sep;14(3):299-304. doi: 10.1067/mva.1991.30618.
Since the natural history of specific superficial femoral artery stenoses is not known, we examined progression rates of superficial femoral artery stenoses in 45 lower extremities found when arteriograms were obtained of 38 patients for symptomatic atherosclerotic disease in the opposite leg or abdomen. These initial superficial femoral artery arteriograms were compared with later arteriograms in 25 limbs, duplex scans in 27 limbs, and both modalities in 7 limbs. After a mean interval of 37 months, most superficial femoral artery stenoses (72%) did not progress. However, 12 superficial femoral artery stenoses progressed (28%; mean follow-up, 37 months, including 7 that occluded (17%). Superficial femoral artery stenoses progressed among patients who complained of symptom progression at a rate faster than that among asymptomatic patients (15.6%/year vs 3%/year; p = 0.006). Superficial femoral artery lesions also progressed more rapidly among patients whose contralateral superficial femoral artery was occluded (10%/year vs 1.6%/year; p = 0.04). By multivariate regression analysis, symptom progression and smoking history were predictive of superficial femoral artery stenosis progression. In the seven patients whose superficial femoral artery stenoses progressed to occlusion, the average rate of stenosis progression was 12%/year (maximum predicted rate, 30% per year by 95% confidence limit). These results indicate that superficial femoral artery stenoses usually progress with synchronous symptomatic deterioration. Other than symptom progression, only cumulative smoking history and contralateral superficial femoral artery occlusion could be associated with superficial femoral artery stenosis progression in this small series.(ABSTRACT TRUNCATED AT 250 WORDS)
由于特定股浅动脉狭窄的自然病程尚不清楚，我们对38例因对侧下肢或腹部症状性动脉粥样硬化疾病行血管造影时发现的45条下肢的股浅动脉狭窄进展率进行了研究。将这些最初的股浅动脉血管造影与随后25条肢体的血管造影、27条肢体的双功扫描以及7条肢体的两种检查方式进行了比较。平均间隔37个月后，大多数股浅动脉狭窄（72%）未进展。然而，12处股浅动脉狭窄出现进展（28%；平均随访37个月，其中7处闭塞（17%））。主诉症状进展的患者中股浅动脉狭窄进展速度快于无症状患者（15.6%/年对3%/年；p = 0.006）。对侧股浅动脉闭塞的患者中股浅动脉病变进展也更快（10%/年对1.6%/年；p = 0.04）。通过多变量回归分析，症状进展和吸烟史可预测股浅动脉狭窄进展。在7例股浅动脉狭窄进展至闭塞的患者中，狭窄进展的平均速率为12%/年（最大预测速率，95%置信区间为每年30%）。这些结果表明，股浅动脉狭窄通常随症状同步恶化而进展。在这个小系列研究中，除症状进展外，仅有累积吸烟史和对侧股浅动脉闭塞可能与股浅动脉狭窄进展相关。（摘要截短于250字）
