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Medial Sclerosis-Epidemiology and Clinical Significance
Peter Lanzer1, Roberto Ferraresi
1Middle German Heart Center-Bitterfeld, Bitterfeld-Wolfen Health Care Center, Bitterfeld, Germany; Diabetic Foot Unit, Clinica San Carlo, Paderno Dugnano, Milan, Italy.
Deutsches Arzteblatt International
|March 29, 2023
Summary
Medial sclerosis (MeS) significantly increases the risk of critical limb ischemia and amputation. This vascular disease, affecting lower limb arteries, has no current pharmacotherapy, highlighting its serious implications.
Area of Science:
- Vascular Medicine
- Systemic Vascular Diseases
Background:
- Medial sclerosis (MeS) is a chronic vascular condition primarily impacting lower limb arteries.
- Affecting approximately 2.5% of the general population, MeS is more prevalent in men.
Approach:
- This review synthesizes findings from a focused PubMed literature search.
- Analysis of pertinent publications to understand MeS and its clinical impact.
Key Points:
- MeS is a common finding post-limb amputation and a significant risk factor for critical leg ischemia (OR: 13.25) and amputation (RR 2.27).
- Advanced calcification in MeS correlates with higher amputation risk (HR 10.6-15.5) and mortality (OR 5.16).
- MeS negatively impacts outcomes of endovascular and surgical revascularization procedures, with no effective pharmacotherapy available.
Conclusions:
- Medial sclerosis is a critical determinant of lower limb ischemia, amputation, and patient morbidity.
- It poses substantial risks, especially following interventions for peripheral arterial disease.
- Further research into MeS pathogenesis and treatment is warranted.
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