Development of femoral atherosclerosis in relation to flow disturbances.

Angiography and post-mortem studies have indicated that disturbed blood flow may promote atherogenesis. Our aim was to demonstrate flow disturbances in vivo and correlate them to the subsequent development of atherosclerosis. The femoral arteries of 17 patients with early atherosclerosis were studied with cineangiography. The films are digitized and analyzed with an image analysis computer. From the time-intensity curves, the arrival time of the contrast medium at each pixel was calculated. In the resulting parametric images, the computer identified zones of delayed contrast filling, (ZDF) which have been shown to correspond to disturbed flow. The progression or regression of atherosclerosis was followed with another angiography 3 years later by computing changes in edge roughness. Arterial segments without flow disturbances (defined as ZDF) showed a more marked decrease in edge roughness than those with flow disturbances (p < 0.05). In addition, the edge roughness tended to increase more in segments with larger ZDF area. Angiographic studies of fluid mechanics and atherogenesis are feasible, but larger patient materials are needed.