Anatomical Distribution Patterns of Peripheral Arterial Disease According to Patient Characteristics: A Unicentral Cohort Study

Abstract

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.

Anatomical Distribution Patterns of Peripheral Arterial Disease in the Upper Extremities According to Patient Characteristics: A Retrospective Cohort Study

“…In patients with DM, the intermediate part was the site most involved in upper extremity PAD; this is consistent with the observation made by Alghanimi et al that the femoropopliteal segment is the site most involved in PAD in patients with DM. 25 The present study found that PAD coexisting with HTN and DM likely manifests in a stenotic form rather than as an occlusive disease.…”

“…This study is a continuum sub-study of another observational cohort study conducted by Alghanimi et al on lower extremity involvement and anatomical distribution of PAD with different comorbidities in the Saudi population (2023). 25 The present study focused on elucidating the relationship between anatomical sites or distribution patterns in upper extremity PAD and the associated risk factors and comorbidities.…”

“…These lesions were classified according to the following three anatomical partitions after referring to the methodology of similar previous studies on lower extremity PAD. [25][26][27] Shoulder (proximal quarter): subclavian and axillary arteries.…”