[Epidemiology of athrotherombotic lower limb arterial disease]

Area of Science:

• Vascular Medicine
• Cardiovascular Epidemiology

Background:

• Chronic occlusive arterial disease of the lower limbs is a frequent manifestation of systemic atherothrombotic disease.
• Patients with lower limb arterial disease often have asymptomatic lesions in other critical arterial beds.

Purpose of the Study:

• To systematically review the natural history of lower limb arterial disease.
• To determine the prevalence of asymptomatic atherothrombotic lesions in other arterial locations.
• To assess the incidence of systemic complications in patients with lower limb arterial disease.

Main Methods:

• Systematic literature review using Medline, Cochrane database, and bibliographies.
• Inclusion of epidemiological studies assessing systemic complications.
• Analysis of prevalence data for coronary, carotid, renal, and aortic artery disease.

Main Results:

• Cardiovascular mortality is 2% per year, myocardial infarction 3% per year, and cerebrovascular accidents 1-2% per year in asymptomatic patients with a pathological systolic pressure index (< 0.90).
• Prevalence of asymptomatic lesions varies: coronary artery disease (21-69%), carotid artery stenosis (12-59%), renal artery stenosis (14-40%), and abdominal aortic aneurysms (6-14%).
• Systemic complication incidence increases with lower limb arterial disease severity.

Conclusions:

• Asymptomatic atherothrombotic lesions are highly prevalent across multiple arterial networks.
• The high prevalence of these lesions warrants further studies on the clinical benefits of systematic diagnostic investigations.
• Early detection and management of systemic atherothrombotic disease are crucial for reducing cardiovascular morbidity and mortality.