Premature lower extremity atherosclerosis: clinical aspects

Area of Science:

• Vascular Surgery
• Cardiovascular Disease
• Public Health

Background:

• Peripheral arterial disease (PAD) is typically considered a condition affecting the elderly.
• Awareness of PAD, especially in younger adults, is notably low.
• Atherosclerosis is the primary cause of lower limb ischemia in younger populations.

Purpose of the Study:

• To highlight the underdiagnosis of PAD in young adults.
• To emphasize the clinical characteristics and risk factors associated with premature lower extremity atherosclerosis (PLEA).
• To underscore the suboptimal outcomes of surgical interventions in this demographic.

Main Methods:

• Review of clinical manifestations and diagnostic findings in young adults with PLEA.
• Analysis of risk factors, including smoking and family history, in affected individuals.
• Evaluation of angiographic data and outcomes of surgical revascularization.

Main Results:

• Young adults with PLEA often present with multiple cardiovascular risk factors, predominantly smoking and a strong family history.
• Over 70% of PLEA patients exhibit severe aortoiliac disease on angiography.
• Surgical revascularization outcomes in younger patients are inferior, with a higher need for repeat procedures and amputation rates.

Conclusions:

• PAD should be considered in adults of any age presenting with appropriate symptoms and multiple risk factors.
• There is a critical need to enhance public health awareness regarding premature lower extremity atherosclerosis.
• Timely diagnosis and management strategies for PAD in young adults require further investigation and public health initiatives.