Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, AlKhobar City, Eastern Province, Saudi Arabia.
College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, AlKhobar City, Eastern Province, Saudi Arabia.
Vasc Health Risk Manag. 2023 Jul 17;19:447-457. doi: 10.2147/VHRM.S416967. eCollection 2023.
Peripheral arterial disease (PAD) is a common disease with multiple risk factors and affects patients worldwide. Several international studies have established correlations between anatomical topography/distribution of atherosclerosis and comorbidities in patients with PAD. In this cohort study, we aimed to analyze the patterns of atherosclerosis (site, distribution, and degree) in patients who underwent lower limb computed tomography angiography and arterial angiography by identifying the atherosclerotic plaque(s) that were possibly responsible for thrombi. Additionally, we aimed to determine any relationship between comorbidities and identified patterns.
Between January 2015 and January 2021, we retrospectively recruited 140 patients at King Fahd Hospital of the University of Saudi Arabia. Data collected included patient characteristics, risk factors, and metabolic disorders, such as hypertension (HTN), diabetes mellitus (DM), dyslipidemia, and chronic kidney disease. Patients with incomplete records or unavailable radiological images were excluded.
The infrapopliteal territory was the most common segment that was affected. HTN, DM, and dyslipidemia were found in 81.4%, 77.9%, and 62.9% of patients, respectively. Correlation analyses revealed that DM was the only independent metabolic disorder associated with a PAD distribution pattern in the femoropopliteal segment (p=0.039), thus denoting distal involvement. No significant association was found between PAD distribution and the severity of stenosis.
Segmental involvement in PAD varies with the risk factors and metabolic comorbidities present in patients. DM is an independent predictor of the anatomical distribution of PAD. The identification of such an anatomical distribution is paramount for screening procedures, early detection of disease, and prevention of complications, particularly limb amputation.
外周动脉疾病（PAD）是一种常见疾病，具有多种危险因素，影响全球患者。几项国际研究已经确定了 PAD 患者的动脉粥样硬化解剖学分布/分布与合并症之间的相关性。在这项队列研究中，我们旨在通过识别可能导致血栓形成的动脉粥样硬化斑块，分析接受下肢计算机断层血管造影和动脉血管造影的患者的动脉粥样硬化模式（部位、分布和程度）。此外，我们旨在确定合并症与已识别模式之间的任何关系。
2015 年 1 月至 2021 年 1 月，我们在沙特阿拉伯国王法赫德大学医院回顾性招募了 140 名患者。收集的数据包括患者特征、危险因素和代谢紊乱，如高血压（HTN）、糖尿病（DM）、血脂异常和慢性肾脏病。排除记录不完整或影像学图像不可用的患者。
最常见的受累节段是腘下区域。HTN、DM 和血脂异常分别在 81.4%、77.9%和 62.9%的患者中发现。相关性分析显示，DM 是与股腘段 PAD 分布模式相关的唯一独立代谢紊乱（p=0.039），表示远端受累。PAD 分布与狭窄严重程度之间没有发现显著相关性。
PAD 的节段性受累因患者存在的危险因素和代谢合并症而异。DM 是 PAD 解剖分布的独立预测因子。识别这种解剖分布对于筛查程序、早期发现疾病和预防并发症（特别是肢体截肢）至关重要。
