Vascular Health and Risk Management (Jul 2023)
Anatomical Distribution Patterns of Peripheral Arterial Disease According to Patient Characteristics: A Unicentral Cohort Study
Abstract
Ibrahim Abobaker Alghanimi,1 Abdulaziz Mohammad Al-Sharydah,1 Afnan Amro Alqutub,2 Nehal Zeidan,2 Fatimah Bukhamseen,2 Alzahra Alradhi,2 Aqilah Taleb Alqassab,2 Mohammed Saad Al-Aftan1 1Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, AlKhobar City, Eastern Province, Saudi Arabia; 2College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, AlKhobar City, Eastern Province, Saudi ArabiaCorrespondence: Ibrahim Abobaker Alghanimi, Assistant Professor and Consultant of Radiology, Vascular and Interventional Radiologist, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Radiology Department, King Fahd Hospital of the University, Khobar City, Eastern Province, Saudi Arabia, Tel +138957999 Ext 2007, Email [email protected]: 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.Patients and Methods: 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.Results: 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.Conclusion: 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.Keywords: angiography, computed tomography, diabetes mellitus, peripheral arterial disease, stenosis
