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Arterial collateral vessels in legs with obliterative arteriosclerosis
Insights
This study introduces a new method to assess arterial blockages in legs using arteriograms. It found a strong link between the number of collateral vessels and the severity of arterial narrowing, aiding in diagnosing peripheral artery disease.
Area of Science:
- Vascular Surgery
- Radiology
- Biomedical Engineering
Background:
- Peripheral artery disease (PAD) significantly impacts lower limb circulation.
- Assessing arterial stenosis and collateral circulation is crucial for PAD diagnosis and management.
- Current methods may not fully capture the complex interplay between stenosis and collateral compensation.
Purpose of the Study:
- To present a novel method for evaluating arterial collateral vessels and stenoses using arteriography.
- To correlate the number of collateral vessels with the degree of arterial lumen narrowing in arteriosclerotic legs.
Main Methods:
- A geometric method was developed to assess collateral vessels bypassing arterial stenoses.
- Collateral vessels were counted, and minimum lumen diameters of arterial segments (common iliac, external iliac/common femoral, superficial femoral arteries) were measured.
- Correlation analysis was performed on data from thirty-four legs.
Main Results:
- A significant negative correlation (r = -0.77, P < 0.001) was found between the sum of remaining lumen diameters and the sum of collateral vessels.
- Maximum lower leg blood flow during exercise correlated better with pelvic arterial disease than femoral artery disease.
- Abundant collateral vessels were observed in patients with central arterial stenoses or occlusions.
Conclusions:
- The presented method effectively quantifies collateral vessel compensation for arterial stenoses.
- Collateral vessel assessment is a valuable addition to the evaluation of peripheral artery disease.
- Central arterial lesions are associated with more extensive collateral development.
Abstract:
A method for assessment of arterial collateral vessels and corresponding stenoses on arteriograms of arteriosclerotic legs is presented. The method is based on the concept that compensatory collateral vessels, by-passing stenoses of the conductive arterial segments, have to cross a plane traversing the distal part of each segment (common iliac artery, external iliac/common femoral artery and superficial femoral artery). The number of collateral vessels was counted and the minimum diameter within the corresponding conductive arterial segment was measured (three locations in each leg). There was a close correlation between the sum of remaining lumen diameters and the sum of corresponding collaterals in thirty-four legs (r = -0.77, P less than 0.001). Maximum lower leg blood flow during exercise (thermodilution) was better correlated to arteriosclerotic changes in the pelvic arterial tree than to changes in the femoral arteries, and the must abundant collateral vessels were found in individuals having central stenoses or occlusions.