Kongkunnavat Natthapong, Tianrungroj Jirapat, Yodrabum Nutcha
Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Plast Reconstr Surg Glob Open. 2023 Jan 27;11(1):e4791. doi: 10.1097/GOX.0000000000004791. eCollection 2023 Jan.
The atherosclerotic cardiovascular disease (ASCVD) risk score is used to estimate coronary artery disease and stroke risk. Atherosclerosis affects arteries throughout the body, including the legs, causing peripheral arterial disease. Atherosclerosis causes luminal stenosis in popliteal artery branches, which affects operative decisions such as intravascular surgery, and lower limb reconstruction. The objective was to investigate the relationship between the ASCVD risk score and degree of stenosis among the popliteal artery and its branches.
The data regarding all patients who underwent computed tomography angiography (CTA) of the legs during 2016-2021 with complete data for ASCVD risk score assessment were recruited. The association between luminal stenosis from CTA and calculated ASCVD risk score was analyzed.
A total of 383 limbs of 117 men and 81 women, averaged 66.5 years old, were studied. Common comorbidities included hypertension (84.3%), diabetes mellitus (61.1%), and chronic kidney disease (34.3%). Average 10-year ASCVD risks in the greater than or equal to 50% stenosis group of popliteal, anterior tibial, and posterior tibial arteries were significantly higher than the less than 50% stenosis group ( < 0.01). The peroneal artery had no significant difference between stenosis groups. The popliteal artery had significantly higher lifetime ASCVD risks than in the greater than or equal to 50% stenosis group ( < 0.01), but the other arteries showed no statistically significant difference.
The 10-year ASCVD risks showed significant higher values in the greater than or equal to 50% stenosis group of popliteal, anterior tibial, and posterior tibial arteries. These findings can establish the further study on how ASCVD risks can be applied to predict the stenosis of these arteries and guide the rationale of preoperative leg CTA for FFF harvest.
动脉粥样硬化性心血管疾病（ASCVD）风险评分用于估计冠心病和中风风险。动脉粥样硬化会影响全身动脉，包括腿部，导致外周动脉疾病。动脉粥样硬化会导致腘动脉分支管腔狭窄，这会影响诸如血管内手术和下肢重建等手术决策。目的是研究ASCVD风险评分与腘动脉及其分支狭窄程度之间的关系。
招募了2016年至2021年期间接受腿部计算机断层扫描血管造影（CTA）且有完整ASCVD风险评分评估数据的所有患者的数据。分析了CTA管腔狭窄与计算得出的ASCVD风险评分之间的关联。
共研究了117名男性和81名女性的383条肢体，平均年龄66.5岁。常见合并症包括高血压（84.3%）、糖尿病（61.1%）和慢性肾脏病（34.3%）。腘动脉、胫前动脉和胫后动脉狭窄程度大于或等于50%组的平均10年ASCVD风险显著高于狭窄程度小于50%组（<0.01）。腓动脉狭窄组之间无显著差异。腘动脉狭窄程度大于或等于50%组的终身ASCVD风险显著更高（<0.01），但其他动脉无统计学显著差异。
腘动脉、胫前动脉和胫后动脉狭窄程度大于或等于50%组的10年ASCVD风险显著更高。这些发现可为进一步研究如何将ASCVD风险应用于预测这些动脉的狭窄以及指导术前腿部CTA用于游离腓骨瓣采集的合理性奠定基础。
