[Atherosclerosis of mesenteric arteries in patients with infrainguinal arterial disease]

The purpose of our study was to analyze the contribution of atherosclerosis the mesenteric arteries to the development of gastroduodenal zone diseases in patients with various-severity chronic ischemia of the lower extremities.

The study included a total of 91 patients with atherosclerosis and chronic lower limb ischemia (CLLI), among them 71 (78.0%) men and 20 (22.0%) women. All patients underwent the following examinations: multislice computed tomoangiography of the abdominal aorta visceral branches and arteries of the lower extremities, esophagogastroduodenoscopy with histological examination of biopsy specimens according to the OLGA (Operative Link on Gastritis Assessment) staging system. Statistical parameters were calculated using IBM SPSS Statistics version 19.

The incidence of atherosclerosis of the mesenteric arteries (MA) in the study group was 52.7%, with combined lesions of the celiac trunk (CT) and superior mesenteric artery (SMA) revealed in 52.1% of patients. A positive correlation was registered between the degree of SMA stenosis and the severity of CLLI ( =0.193; p=0.036). In patients with hemodynamically significant MA stenosis, a higher incidence of erosive and ulcerative pathology of the gastroduodenal zone was recorded, primarily due to gastric ulcer in the acute stage. A positive correlation was revealed between the percentage of SMA stenosis and the severity of the erosive and ulcerative process in the gastroduodenal zone according to the Cryer scale ( =0.337; p=0.031) and the modified Lanza scale ( =0.405; p=0.010), as well as a positive relationship between the degree of CT stenosis and severity of atrophic gastritis according to the OLGA staging system ( =0.264; p=0.020). Based on multiple logistic regression, the following factors were identified as associated with erosive-ulcerative gastroduodenopathy: the presence of MA atherosclerosis (OR 4.148; 95% CI 1.403-12.262; p=0.010), an increase in the total score of the Hospital Anxiety and Depression Scale (OR 1.340; 95% CI 1.118-1.606; p=0.002), and the level of alcohol consumption according to the Alcohol Use Disorders Identification Test (OR 1.166; 95% CI 1.017-1.337; p=0.028).

A positive correlation was revealed between the percentage of SMA stenosis and the severity of CLLI. In patients with hemodynamically significant MA stenosis, erosive and ulcerative lesions of the gastroduodenal zone are more common. The following factors associated with erosive and ulcerative gastroduodenopathy were identified: the presence of MA atherosclerosis, an increase in the total score of the HADS and the level of alcohol consumption according to the AUDIT questionnaire.