Angiographische Evaluation der Prädilektionsstellen der pAVK im infrarenalen Bereich

The peripheral arterial disease (pad) is a multifactoriell caused disease with high prevalence in the population. The getABI study showed that nearly 20% of adults aged 65-years and older suffer from pad. OBJECTIVE: The purpose of our study was to retrospectively evaluate the impact of the common cardiovascular risk factors (cigarette smoking, diabetes, hyperlipidemia, hypertension, etc.) on the anatomic site of the pad in lower extremities and to compare our results with the results of Henry Haimovici´s “patterns of arteriosclerotic lesions of the lower extremity.” MATERIALS AND METHODS: Digital subtraction angiographies of 1014 patients with chronical pad were screened and all arteries were systematically analysed from the infrarenal aorta down to the pedal vessels. Patients with insufficient quality of the angiogram, acute limb ischaemia (thrombotic occlusion, embolism) or patients who had undergone vascular surgery (PTA, bypass, amputation, TEA) were excluded from the study. RESULTS: Our angiographic evaluation showed that arteriosclerosis in the distal segments of the lower extremity (popliteal and infrapopliteal region) occured more frequently in diabetics and patients with renal insufficiency. Smokers appeared to have more common occlusive disease in the proximal segments (aortoiliac and femoral region) of the lower limb. The existence of other cardiovascular risk factors (hyperlipidemia, high blood pressure, coronary heart disease, etc.) did not correlate with the site of the arteriosclerotic disease. CONCLUSION: Further studies are required to verify why patiens with diabetes and renal insufficiency have significantly more occlusion in the distal region and why smokers tend to present more arteriosclerotic lesion in the proximal segments of the lower extremity.