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

IF 2.6 Q2 PERIPHERAL VASCULAR DISEASE

Vascular Health and Risk Management Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI:10.2147/VHRM.S440408

Abdulaziz Mohammad Al-Sharydah, Khaled Saud AlZahrani, Ibrahim Abobaker Alghanimi, Maha Mukhlef AlAnazi, Razan Essam AlHarbi

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引用次数: 0

Abstract

Purpose: Peripheral arterial disease (PAD) greatly affects the patients' quality of life. We aimed to investigate the affected anatomical sites and distribution patterns in upper extremity PAD using computed tomography angiography (CTA). Furthermore, we sought to identify the correlations between patient characteristics and the identified patterns.

Patients and methods: This was a retrospective chart review of upper limb CTA findings from patients with symptomatic PAD aged >18 years. Significant variables from univariate logistic regression analysis were further tested using multivariate logistic regression analysis. Statistical significance was set at p < 0.05, with confidence intervals of 95%.

Results: The mean age of the 102 included patients with upper extremity PAD was 55.45 years. Laterality analysis revealed that the upper left limb segments were more affected than the upper right limb segments (42 vs 63; left-to-right ratio, 3:2). The forearm was the segment most affected by stenotic PAD (62 segments, 3.37%). The arm was the segment most affected by occlusive PAD (14 segments, 0.76%). Diabetes mellitus (DM) and hypertension (HTN) were significant predictors of PAD (p = 0.046). In patients with DM, the occlusive form of PAD was dominant in the arm (18.18%); however, the stenotic form prevailed in the forearm (72.72%). In patients with HTN, the occlusive form of PAD was predominant in the arm (45.45%); however, the stenotic form tended to occur in the arm and forearm (90.90%).

Conclusion: The distribution patterns of upper extremity PAD are linked to its underlying pathophysiology. HTN and DM are the most frequent comorbidities in patients with upper extremity PAD. Angiographically, PAD in these patients is likely to present as stenosis rather than as occlusion. This is vital for interventionists who deviate from radial arterial access in patients with PAD. Therefore, targeted screening standards are required, and further studies on PAD are warranted.

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根据患者特征确定上肢外周动脉疾病的解剖分布模式：一项回顾性队列研究

目的：外周动脉疾病（PAD）严重影响患者的生活质量。我们旨在使用计算机断层扫描血管造影术（CTA）研究上肢 PAD 受影响的解剖部位和分布模式。此外，我们还试图确定患者特征与已确定模式之间的相关性：这是一项对年龄大于 18 岁的有症状 PAD 患者上肢 CTA 检查结果的回顾性病历审查。使用多变量逻辑回归分析进一步检验了单变量逻辑回归分析中的重要变量。统计显著性以 p < 0.05 为标准，置信区间为 95%：102 名上肢 PAD 患者的平均年龄为 55.45 岁。侧位分析显示，左上肢比右上肢受影响更大（42 对 63；左右比为 3:2）。前臂是受狭窄性 PAD 影响最严重的肢体（62 个肢体，3.37%）。手臂是受闭塞性 PAD 影响最严重的部位（14 节，0.76%）。糖尿病（DM）和高血压（HTN）是预测 PAD 的重要因素（p = 0.046）。在 DM 患者中，闭塞型 PAD 主要发生在手臂（18.18%）；然而，狭窄型 PAD 主要发生在前臂（72.72%）。在高血压患者中，闭塞型PAD主要发生在手臂（45.45%）；然而，狭窄型PAD主要发生在手臂和前臂（90.90%）：结论：上肢PAD的分布模式与其潜在的病理生理学有关。高血压和糖尿病是上肢 PAD 患者最常见的合并症。从血管造影来看，这些患者的 PAD 很可能表现为血管狭窄而非闭塞。这对于偏离桡动脉入路治疗 PAD 患者的介入医生来说至关重要。因此，需要制定有针对性的筛查标准，并对 PAD 进行进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular Health and Risk Management PERIPHERAL VASCULAR DISEASE-

CiteScore

4.20

自引率

3.40%

发文量

109

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.