Doppler Ultrasonography Screening of the Lower Limbs in Patient with Coronary Artery Disease

A B S T R A C T

Introduction: For patient with coronary artery disease (CAD), peripheral artery disease (PAD) is really underestimated.
Objectives: Establish a mapping of atherosclerotic involvement of the lower limbs using ultrasound exploration, by working on a sample of coronary artery disease (CAD) patients, recruited in cardiology at the university hospital centers of the city of Constantine.
Patients and Methods: Our study is descriptive, transversal, and multi-centric carried out in unit of cardiovascular explorations of the University Hospital of Constantine. The patients involved had at least one significant coronary lesion ≥ 50 on a principal coronary artery. All of our patients benefited from a lower limb Doppler ultrasonography using a 12L linear scanning probe on a General Electric vivid E9 ultrasound system. The data processing and processing used epi info 8 software.
Results: Atheromatous affection and implication of the lower limbs is very common and usual in patient with coronary artery disease (CAD), mostly on the infra popliteal floor. 34.67% have a hemodynamic lesion ≥ 50% on the arterial axes of the lower limbs. Taking the lion’s share, with more than half of our population had predominantly distal mediacalcosis lesions.
Conclusion: Atherothrombotic disease or atherothrombosis demands a global patient care since for a long time and for as long as anyone can remember, the clinical translations and manifestations of atherothrombosis were treated in isolation and compartmentalized.

Keywords

Atheromatous-plaque, media-calcinosis, peripheral artery disease, coronary artery disease

Introduction

The atherosclerosis is a diffuse process that can affect different vascular regions with considerable overlap between cardiovascular disease (CVD) (like: coronary artery disease “CAD”), cerebrovascular disease (like: stroke) and peripheral arterial disease (like: PAD). In the literature among patients with coronary artery disease (CAD), 7.7% to 19.6% have already carotid stenosis coexisted and 22-42% have peripheral arterial disease [1]. These associations and compact cause a higher mortality and higher rates of vascular events [1]. However, there are few studies interested in establishing peripheral vascular check in patients with a coronary artery disease (CAD). The main intention of this current study is to map the atherosclerotic affection of the lower limbs in a population with coronary artery disease (CAD) using vascular ultrasound.

Patients and Methods

I Population

Our epidemiological study is observational, descriptive, analytical and multicentric, carried out on a sample of 300 confirmed patients with coronary artery disease (CAD) from the three university hospital centers of the city of Constantine. The patients included had at least a ≥ 50% lesion on a principle coronary artery, regardless of their age and sex, excluding those who refused to participate in this study and patients with acute limb ischaemia (ALI); informed besides free consent and patient engagement for this project are required, respecting privacy and anonymity.

II Methods

On the day of the vacation, the patients included benefited from a collection of anthropometric measurements (weight, height, calculation of the BMI), an assortment of information (CVRF, cardio-cerebrovascular disease), a complete clinical examination, a biological assessment including the complete lipid profile (HDLc, CHOLt, TG, LDLc), fasting blood sugar, creatinine level and calculates creatinine clearance using the MDRD formula. For all our patients, a Doppler Ultrasound of lower limb (DULL) was carried out by a General Electric vivid E9 ultrasound machine started up in January 2014, using a 12L linear scanning probe, intended for peripheral vascular exploration, making it possible to obtain targeted screening and to have a precise and explicit lesion description. This exploration concerns the entire arterial tree. In each territory, the exploration is carried out in a patient at rest, in decubitus (recumbency) and systematized according to a specific protocol for each territory. A Doppler Ultrasound of lower limbs (DULL) is pathological, if the presence of at least one atheromatous plaque (atheroma) and/or a hemodynamic lesion ≥ 50% on one of the arterial axes of the lower limbs (aortoiliac, femoropopliteal and infra-popliteal), based on velocimetric criteria (measurement of systolic velocity (PSV) and the ratio of velocities by pulsed Doppler, in the site of the stenosis and before it; in the iliac level, for a stenosis ≥ 50%, a PSV> 200-250 cm/s, and a PSV ratio> 2 to 2.5; at the sub inguinal level, a ratio greater than 2.5 to 3 is generally accepted to differentiate stenosis of more than 50% [2].

III Statistical Analysis

Patient data as well as all the examinations were carried out by the same cardiologist (principal investigator), subsequently recorded initially on a datasheet established for this purpose/reason, later transferred to a database (EXCEL 2013 file) designed for the same purpose. Statistical analysis is performed using epi info 8 software. Results are presented with 95% confidence intervals, as mean, median, standard deviation, and minimum and maximum values, for the quantitative variables. Whereas, percentages with their standard deviation for the categorical variables. The comparison tests used are: Pearson's Chi-Squared Test (χ2 test) and Fisher's exact test to calculate and conclude the percent difference comparisons. Student’s t-test or Mann-Whitney U test are used to calculate and extract the comparison of means. The threshold of statistical significance is considered reached when the risk of error is less than 5% (p value of <0.05).

Results

I Characteristics of the Common Population

Between June 2015 and March 2016, we gathered/assembled 300 patients with coronary artery disease (CAD) (Table 1). The mean age of this population was 61.3 ± 11.3 years with age extremes ranging from 23 to 85 years, and a median of 62 years, with significant male predominance (78.3%), this population was relatively thin (mean BMI 27.92 ± 4.66 kg/m2, mean waist circumference measurement about 95.55 ± 11.20 cm). The majority of our patients with coronary artery disease (CAD) have more than three CVRFs (72.7%). The principal CVRFs were age (69%), followed by hypertension (HBP) (58.7%), sedentism (57.3%), dyslipidemia (52.7%), overweight (49%) and diabetes (47.4%). Whereas the least observed CVRFs were active smoking (32.3%), obesity (29.3%), and a family history of early cardiovascular disease (CVD) (26.4%). Diabetes is associated with hypertension and dyslipidemia in 36%, 47.3% of cases, respectively; while the triple association is observed in 37.7%. Personal medical history of cerebrovascular diseases (ischaemic and haemorrhagic stroke, TIA), were observed in 2.7%. The majority of our patients (60.7%) had coronary angiography for an acute coronary syndrome (ACS), while the rest for stable ischemic heart disease (SIHD). 41.67% had mono-trunk implication, 30.7% bi-trunk implication and 22% tri-trunk implication and 5.6% left common trunk.

Table 1: Characteristics in the global population.

VARIABLES

RESULTS (n ou %)

Mean age

61 ,3 ± 11,3 years

Sex ratio M/W

3,6

Number ≥ three CVRF

72,7%

Age ≥ 50 years (M) et ≥ 60years (W)

69%

HBP

58,7%

sedentism

57,3%

dyslipidemia

52,7%

diabetes

47,4%

Active smoking

32,3 %

Overweight

49%

Obesity

29,3%

Android obesity

32%

Familial coronary artery disease(CAD)

26,4%

Chronic kidney diseaseCKD

light: 9,7% ; moderate: 5% severe: 1,3%

Personal medical history with cerebrovascular disease

2,7%

Mono-trunk implication

41,67%

Bi-trunk implication

30,7%

tri-Trunk implication

22%.

Atteinte du TCG

5,6%


II Doppler Ultrasonography of the Lower Extremity Arteries Report

During our investigation, a Doppler ultrasonography of the lower extremity arteries was performed for all patients with coronary artery disease (CAD) in order to permit a detailed study of the arterial tree from the abdominal level to the periphery. The lesions identified are the existence of plaques, hemodynamic lesions (≥ 50%), thrombosis, or mediacalcosis.

III Iliac Axis Lesion

The percentage of patients with at least one atheromatous lesion of the iliac axis (common iliac artery, internal iliac artery, external iliac artery) was 47.7%, a very remarkable and significant difference between the two sexes, without the presence of mediacalcosis at this level (Tables 2-4).

Table 2: Distribution of iliac lesions.

 

men

women

Total

P

Without lesion

107 (45,53%)

50 (76,92%)

157 (52,3%)

0,001

Iliac lesion

128 (54,46%)

15 (23,1%)

143 (47,7%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 3: Distribution of the right iliac artery lesions.

 

Men

women

Total

P

Plaques

107 (45,53%)

16 (24,6%)

123 (41,0%)

0,001

stenosis

18 (7,65%)

1 (1,5%)

19 (6,34%)

Thrombosis

1 (0,4%)

0 (0,0%)

1 (0,34%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 4: Distribution of the left iliac artery.

 

Men

women

global Population

P

Plaques

109 (46,3%)

15 (23,1%)

124 (41,3%)

0,001

stenosis

18 (7,65%)

0 (0,0%)

18 (6%)

Thrombosis

1 (0,4%)

0 (0,0%)

1 (0,34%)

Total

235 (100%)

65 (100%)

300 (00%)


IV Femoro-Popliteal Axis Lesion

The percentage of patients with at least one atheromatous lesion of the femoral axis (common femoral artery, superficial femoral artery, deep femoral artery) was 56.0%; this implication is more frequent than the one of the axis iliac, very notable and significant difference between the two sexes and without the presence of mediacalcosis on this level (Tables 5-11).

Table 5: Distribution of the femoro-popliteal lesions.

 

men

women

Total

P

Without lesion

86 (36,6%)

46 (70,8%)

132 (44,0%)

0,001

Axis lesion

149 (63,4%)

19 (29,2%)

168 (56,0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 6: Distribution of the right common femoral artery lesions.

 

men

women

global Population

P

Plaques

94 (40%)

28 (42,8%)

122(40,7%)

0,024

Stenosis

18(7,65%)

0%

18(6,0%)

Thrombosis

2(0,9%)

1(1,5%)

3(1%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 7: Distribution of the left common femoral artery lesions.

 

men

Women

global Population

P

Plaques

92 (39,2%)

28 (42,8%)

120 (40%)

0,03

Stenosis

21 (8,93%)

1 (1,5%)

22 (7,33%)

Thrombosis

1 (0,4%)

0%

1 (0,34%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 8: Distribution of the right superficial femoral artery lesions.

 

men

women

global Population

P

Plaques

103(43,82%)

24(36,90%)

127(42,3%)

0,033

Stenosis

31(13,2%)

1(1,5%)

32(10,7%)

Thrombosis

0(0%)

0(0%)

0(0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 9: Distribution of the left superficial femoral artery lesions.

 

men

women

global Population

P

Plaques

110(46,80%)

22(33,84%)

132(44 %)

0,014

Stenosis

34(14,46%)

2(3,07%)

36(12%)

Thrombosis

0(0%)

0(0%)

0(0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 10: Distribution of the right femoro-popliteal lesions.

 

men

women

global Population

P

Plaques

30 (42,9%)

98 (41,7%)

128 (42,7%)

0,001

Stenosis

4 (1,8%)

2 (3%)

6 (2%)

Thrombosis

0 (0%)

0 (0%)

0 (0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 11: Distribution of the left femoro-popliteal lesions.

 

men

women

global Population

P

Plaques

90 (38,1%)

24(37,2%)

114(38%)

0,002

Stenosis

12(5,2%)

4(6,1%)

16(5,3%)

Thrombosis

0(0%)

0(0%)

0(0%)

Total

235 (100%)

65 (100%)

300 (100%)


V Infra Popliteal Axis Lesion

The percentage of patients with at least one lesion of the infra-popliteal axis (anterior tibial artery, posterior tibial artery, fibular artery) was 73.0%, constituting the most frequent implication of the arterial axes of the lower limbs; these lesions are dominated by mediacalcosis (Tables 12-18).

Table 12: Distribution of the infra-popliteal axis lesion.

 

men

women

Total

P

Infra- popliteal axis without lesion

69(29,4%)

12(18,5%)

81(27,0%)

0,08

Infra- popliteal axis with lesion

166(70,6%)

53(81,5%)

219(73,0%)

Total

235(100%)

65(100%)

300(100%)

 


Table 13: Distribution of the left anterior tibial artery lesions.

 

men

women

global Population

P

Plaques

80(34%)

12(18,5%)

92(30,7%)

0,01

Stenosis

24 (10,2%)

1(1,5%)

25(8,4%)

Thrombosis

24 (10,2%)

6(9,2%)

30(10,0%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

134(57%)

35(53,8%)

169(56,3%)

0,759


Table 14: Distribution of the right anterior tibial artery lesions.

 

men

women

global Population

P

Plaques

74 (31,5%)

7 (10,8%)

81 (27%)

0,011

Stenosis

21 (8,9%)

5 (7,7%)

26 (8,6%)

Thrombosis

28 (11,9%)

5 (7,7%)

33 (11%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

132 (56,2%)

35 (53,8%)

167 (55,7%)

0,807


Table 15: Distribution of the left posterior tibial artery lesions.

 

men

women

global Population

P

Plaques

92(39,1%)

12 (18,5%)

104 (34,7%)

0,006

Stenosis

14 (6%)

3 (4,6%)

17 (5,7%)

Thrombosis

22 (9,4%)

5 (7,7%)

27 (9%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

133(56,6%)

35(53,8%)

168(56,0%)

0,784


Table 16: Distribution of the right posterior tibial artery lesions.

 

men

women

global Population

P

Plaques

92(39,1%)

14(21,5%)

106(35,3%)

0,007

Stenosis

11(4,6%)

2(3,1%)

13(4,3%)

Thrombosis

24(10,2%)

5(7,7%)

29(9,7%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

133 (56,2%)

35(53,8%)

167(55,7 Population %)

0,807


Table 17: Distribution of the right peroneal artery lesions.

 

men

women

global Population

P

Plaques

97 (41,3%)

15 (23,1%)

112 (37,3%)

0,025

Stenosis

9 (3,8%)

0 (0%)

9 (3%)

Thrombosis

22 (9,4%)

8 (12,3%)

30 (10,0%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

133 (56,6%)

36 (55,4%)

169 (56,3%)

0,857


Table 18: Distribution of the left peroneal artery lesions.

 

men

women

global Population

P

Plaques

101(43%)

13(20%)

114(38%)

0,002

Stenosis

10(4,2%)

0(0%)

10(3,3%)

Thrombosis

22(9,4%)

8(12,3%)

30(10%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

131 (55,7%)

36 (55,4%)

167 (55,7%)

0,880


VI Distribution of Atherosclerotic Lesions According to the Data of the Doppler Ultrasound of Lower Limbs

104 patients had at least one hemodynamic atherosclerotic lesion ≥ 50% on the arterial axes of the lower limbs representing 34.67%. These lesions predominate in the femoro-popliteal axis, but thrombotic lesions are found much more on the infra-popliteal level. More than half of our population of patients with coronary artery disease had mediacalcosis as lesion (Table 19).

Table 19: Distribution of atheromatous lesions of the lower limbs.

Percentage of patients with at least one atherosclerotic lesion of the arterial axes of lower limbs

Artery

patients number

(lesions≥50%)

patients number

(thrombosis)

Percentage of patients with hemodynamic lesion

Iliac Axis (47, 7%)

LIA

18

1

6,34%

RIA

19

1

6,67 %

femoro-popliteal Axis (56%)

LCFA

22

1

7,66%

RCFA

18

3

7%

LSFA

36

0

12%

RSFA

32

0

10,7%

LFPA

16

0

5,3%

RFPA

06

0

2%

infra popliteal Axis (73%)

LATA

25

30

18,4%

RATA

26

33

19,6%

LPTA

17

27

14,7%

RPTA

13

29

14%

LPA

10

30

13,3%

RPA

09

30

13%


Discussion

PAD includes all locations and regions from the large proximal arteries to the more distal small arteries, from the abdominal aorta to the distal vessels. There is no referential rule for PAD to distinguish and choose large and small arteries. Some authors consider a small artery, the one with a diameter of less than 2.3 mm, which corresponds to the most distal arteries, but other studies compare infra-knee joint with supra-knee joint atheromatous lesions [3-6]. Peripheral arterial disease (PAD) is an indicator of atherosclerosis in other vascular regions and also associated with a huge and considerable morbidity and mortality [1]. In patients with coronary artery disease (CAD), a coexisting atherosclerotic lesion of the lower limbs has been reported in 15-42% according to the different epidemiological series [1].

In our current study, the frequency of PAD in patients with coronary artery disease (CAD)was really high (34.67%). We find that there is a distal damage more frequent than proximal. This has been demonstrated in other recent studies such as the study of De Neuville in 2008, including 754 patients, focused on the PAD description of the West Indian subject (France) by analysis of a surgical employment of database, which showed that hemodynamic damages affected the infra-popliteal level in 86% of cases, the femoro-popliteal axis in 51%, but in only 7% of cases the aortoiliac level; the Copart register in 2013, 60.2% of patients at Toulouse University Hospital and 73.5% patients of Bordeaux and Limoges University Hospital Centers have infra-popliteal lesion and in 2014, Lavinia Belaye, in a work aimed at identifying the predominant localization of PAD, and the CVRFs influencing its topography, found the predominance of distal PAD in the 268 patients included in the study, 84.70% patients had an infra-popliteal implication, and respectively a popliteal implication 55.22%, femoral 69.02% and aortoiliac 42.91% [7-9].

Conclusion

Due to its dispersed and ubiquitous nature, atherothrombotic disease needs a serious and a strict patient’s care because, for a long time, the clinical translation with manifestations of atherothrombosis disease (myocardial infarction, stroke etc.) were treated in an isolated and sectionalized manner, but today, the modern vision describes a systemic disease, which can potentially affect several and various arteries simultaneously, which justifies a minimum evaluation and a strict analysis including the three major territories: coronary, cerebrovascular and peripheral, this Is due to the magnificent progress in investigative methods, especially the non-invasive ones, pushing to a systematic and a professional search for atheromatous disease and concomitantly with a preventive treatment of silent lesions.

Conflicts of Interest

None.

Article Info

Article Type
Research Article
Publication history
Received: Tue 01, Sep 2020
Accepted: Tue 06, Oct 2020
Published: Mon 19, Oct 2020
Copyright
© 2021 Rachid Merghit. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.CDM.2020.01.05

Author Info

Corresponding Author
Rachid Merghit
Cardiology Service, University Hospital Center, Ali Mendjli Constantine, 25000, Algeria

Figures & Tables

Table 1: Characteristics in the global population.

VARIABLES

RESULTS (n ou %)

Mean age

61 ,3 ± 11,3 years

Sex ratio M/W

3,6

Number ≥ three CVRF

72,7%

Age ≥ 50 years (M) et ≥ 60years (W)

69%

HBP

58,7%

sedentism

57,3%

dyslipidemia

52,7%

diabetes

47,4%

Active smoking

32,3 %

Overweight

49%

Obesity

29,3%

Android obesity

32%

Familial coronary artery disease(CAD)

26,4%

Chronic kidney diseaseCKD

light: 9,7% ; moderate: 5% severe: 1,3%

Personal medical history with cerebrovascular disease

2,7%

Mono-trunk implication

41,67%

Bi-trunk implication

30,7%

tri-Trunk implication

22%.

Atteinte du TCG

5,6%


Table 2: Distribution of iliac lesions.

 

men

women

Total

P

Without lesion

107 (45,53%)

50 (76,92%)

157 (52,3%)

0,001

Iliac lesion

128 (54,46%)

15 (23,1%)

143 (47,7%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 3: Distribution of the right iliac artery lesions.

 

Men

women

Total

P

Plaques

107 (45,53%)

16 (24,6%)

123 (41,0%)

0,001

stenosis

18 (7,65%)

1 (1,5%)

19 (6,34%)

Thrombosis

1 (0,4%)

0 (0,0%)

1 (0,34%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 4: Distribution of the left iliac artery.

 

Men

women

global Population

P

Plaques

109 (46,3%)

15 (23,1%)

124 (41,3%)

0,001

stenosis

18 (7,65%)

0 (0,0%)

18 (6%)

Thrombosis

1 (0,4%)

0 (0,0%)

1 (0,34%)

Total

235 (100%)

65 (100%)

300 (00%)


Table 5: Distribution of the femoro-popliteal lesions.

 

men

women

Total

P

Without lesion

86 (36,6%)

46 (70,8%)

132 (44,0%)

0,001

Axis lesion

149 (63,4%)

19 (29,2%)

168 (56,0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 6: Distribution of the right common femoral artery lesions.

 

men

women

global Population

P

Plaques

94 (40%)

28 (42,8%)

122(40,7%)

0,024

Stenosis

18(7,65%)

0%

18(6,0%)

Thrombosis

2(0,9%)

1(1,5%)

3(1%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 7: Distribution of the left common femoral artery lesions.

 

men

Women

global Population

P

Plaques

92 (39,2%)

28 (42,8%)

120 (40%)

0,03

Stenosis

21 (8,93%)

1 (1,5%)

22 (7,33%)

Thrombosis

1 (0,4%)

0%

1 (0,34%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 8: Distribution of the right superficial femoral artery lesions.

 

men

women

global Population

P

Plaques

103(43,82%)

24(36,90%)

127(42,3%)

0,033

Stenosis

31(13,2%)

1(1,5%)

32(10,7%)

Thrombosis

0(0%)

0(0%)

0(0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 9: Distribution of the left superficial femoral artery lesions.

 

men

women

global Population

P

Plaques

110(46,80%)

22(33,84%)

132(44 %)

0,014

Stenosis

34(14,46%)

2(3,07%)

36(12%)

Thrombosis

0(0%)

0(0%)

0(0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 10: Distribution of the right femoro-popliteal lesions.

 

men

women

global Population

P

Plaques

30 (42,9%)

98 (41,7%)

128 (42,7%)

0,001

Stenosis

4 (1,8%)

2 (3%)

6 (2%)

Thrombosis

0 (0%)

0 (0%)

0 (0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 11: Distribution of the left femoro-popliteal lesions.

 

men

women

global Population

P

Plaques

90 (38,1%)

24(37,2%)

114(38%)

0,002

Stenosis

12(5,2%)

4(6,1%)

16(5,3%)

Thrombosis

0(0%)

0(0%)

0(0%)

Total

235 (100%)

65 (100%)

300 (100%)


Table 12: Distribution of the infra-popliteal axis lesion.

 

men

women

Total

P

Infra- popliteal axis without lesion

69(29,4%)

12(18,5%)

81(27,0%)

0,08

Infra- popliteal axis with lesion

166(70,6%)

53(81,5%)

219(73,0%)

Total

235(100%)

65(100%)

300(100%)

 


Table 13: Distribution of the left anterior tibial artery lesions.

 

men

women

global Population

P

Plaques

80(34%)

12(18,5%)

92(30,7%)

0,01

Stenosis

24 (10,2%)

1(1,5%)

25(8,4%)

Thrombosis

24 (10,2%)

6(9,2%)

30(10,0%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

134(57%)

35(53,8%)

169(56,3%)

0,759


Table 14: Distribution of the right anterior tibial artery lesions.

 

men

women

global Population

P

Plaques

74 (31,5%)

7 (10,8%)

81 (27%)

0,011

Stenosis

21 (8,9%)

5 (7,7%)

26 (8,6%)

Thrombosis

28 (11,9%)

5 (7,7%)

33 (11%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

132 (56,2%)

35 (53,8%)

167 (55,7%)

0,807


Table 15: Distribution of the left posterior tibial artery lesions.

 

men

women

global Population

P

Plaques

92(39,1%)

12 (18,5%)

104 (34,7%)

0,006

Stenosis

14 (6%)

3 (4,6%)

17 (5,7%)

Thrombosis

22 (9,4%)

5 (7,7%)

27 (9%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

133(56,6%)

35(53,8%)

168(56,0%)

0,784


Table 16: Distribution of the right posterior tibial artery lesions.

 

men

women

global Population

P

Plaques

92(39,1%)

14(21,5%)

106(35,3%)

0,007

Stenosis

11(4,6%)

2(3,1%)

13(4,3%)

Thrombosis

24(10,2%)

5(7,7%)

29(9,7%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

133 (56,2%)

35(53,8%)

167(55,7 Population %)

0,807


Table 17: Distribution of the right peroneal artery lesions.

 

men

women

global Population

P

Plaques

97 (41,3%)

15 (23,1%)

112 (37,3%)

0,025

Stenosis

9 (3,8%)

0 (0%)

9 (3%)

Thrombosis

22 (9,4%)

8 (12,3%)

30 (10,0%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

133 (56,6%)

36 (55,4%)

169 (56,3%)

0,857


Table 18: Distribution of the left peroneal artery lesions.

 

men

women

global Population

P

Plaques

101(43%)

13(20%)

114(38%)

0,002

Stenosis

10(4,2%)

0(0%)

10(3,3%)

Thrombosis

22(9,4%)

8(12,3%)

30(10%)

Total

235(100%)

65(100%)

300(100%)

Mediacalcosis

131 (55,7%)

36 (55,4%)

167 (55,7%)

0,880


Table 19: Distribution of atheromatous lesions of the lower limbs.

Percentage of patients with at least one atherosclerotic lesion of the arterial axes of lower limbs

Artery

patients number

(lesions≥50%)

patients number

(thrombosis)

Percentage of patients with hemodynamic lesion

Iliac Axis (47, 7%)

LIA

18

1

6,34%

RIA

19

1

6,67 %

femoro-popliteal Axis (56%)

LCFA

22

1

7,66%

RCFA

18

3

7%

LSFA

36

0

12%

RSFA

32

0

10,7%

LFPA

16

0

5,3%

RFPA

06

0

2%

infra popliteal Axis (73%)

LATA

25

30

18,4%

RATA

26

33

19,6%

LPTA

17

27

14,7%

RPTA

13

29

14%

LPA

10

30

13,3%

RPA

09

30

13%


References

  1. Dormandy JA, Rutherford RB (2000) Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg 31: S1-S296. [Crossref]
  2. Dharmasaroja PA, Piyayotai D, Hutayanon P, Buakhamsri A, Intharakham K (2010) Extracranial carotid stenosis and peripheral arterial disease in Thai patients with coronary artery disease. Angiology 61: 329-332. [Crossref]
  3. Pasternak RC, Criqui MH, Benjamin EJ, Fowkes FGR, Isselbacher EM et al. (2004) Atherosclerotic Vascular Disease Conference: Writing Group I: epidemiology. Circulation 109: 2605-2612. [Crossref]
  4. Strandness DE Jr, Priest RE, Gibbons GE (1964) Combined Clinical and Pathologic Study of Diabetic and Nondiabetic Peripheral Arterial Disease. Diabetes 13: 366-372. [Crossref]
  5. van der Feen C, Neijens FS, Kanters SDJM, Th M Mali WP, Stolk RP et al. (2002) Angiographic distribution of lower extremity atherosclerosis in patients with and without diabetes. Diabet Med 19: 366-370. [Crossref]
  6. Vogelberg KH, Berchtold P, Berger H, Gries FA, Klinger H et al. (1975) Primary hyperlipoproteinemias as risk factors in peripheral artery disease documented by arteriography. Atherosclerosis 22: 271-285. [Crossref]
  7. Deneuville M, Pierrot JM, N'Guyen R (2008) Particularities of peripheral arterial disease managed in vascular surgery in the French West Indies. Arch Cardiovasc Dis 101: 23-29. [Crossref]
  8. Pros N, Cambou JP, Aboyans V, Malloizel Delaunay J, Constans J et al. (2013) A hospital discharge risk score for 1-year all-cause mortality or non-fatal cardiovascular events in patients with lower-extremity peripheral artery disease, with and without revascularisation. Eur J Vasc Endovasc Surg 45: 488-496. [Crossref]
  9. Belaye L (2014) L'arteriopathie obliterante des membres inferieurs d'origine atheromateuse en Guadeloupe: une etude descriptive de patients ayant vus en cabinet de medecine vasculaire et au centre d'exploration cardiovasculaire du Centre Hospitalier universitaire. Human health and pathology.