Related Experiment Video
Updated: Aug 29, 2026
A Rabbit Venous Interposition Model Mimicking Revascularization Surgery using Vein Grafts to Assess Intimal Hyperplasia under Arterial Blood Pressure
Published on: May 15, 2020
Progression of atherosclerosis in arteries distal to lower extremity revascularizations
R B McLafferty1, G L Moneta, P A Masser
1Department of Surgery, Oregon Health Sciences University, Portland 97201-3098, USA.
Insights
Atherosclerotic occlusive disease (AOD) progression is common after lower extremity revascularization, particularly with femoropopliteal bypass. Arterial reconstruction does not appear to worsen AOD progression.
Area of Science:
- Vascular Surgery
- Cardiovascular Disease
- Interventional Radiology
Background:
- Atherosclerotic occlusive disease (AOD) affects lower extremities, often requiring revascularization.
- The natural history and progression patterns of AOD post-revascularization remain incompletely understood.
- Understanding AOD progression is crucial for optimizing patient management and long-term outcomes.
Purpose of the Study:
- To characterize the progression of lower extremity atherosclerotic occlusive disease (AOD) following revascularization procedures.
- To compare AOD progression rates between different types of revascularization (e.g., infrainguinal vs. suprainguinal bypass).
- To identify factors associated with AOD progression after surgical intervention.
Main Methods:
- Retrospective analysis of 150 patients undergoing revascularization for lower extremity AOD.
- Follow-up duplex scanning or angiography compared with presurgical arteriograms.
- Grading of superficial femoral arteries (SFA), popliteal arteries, and tibial arteries for stenosis and occlusion.
Main Results:
- AOD progression was observed in 18% of native arteries, 39% of extremities, and 52% of patients at a mean follow-up of 4.8 years.
- Progression was more frequent after infrainguinal bypass (21%) compared to suprainguinal bypass (14%).
- Progression was more commonly detected in studies performed >4 years post-procedure (66%) than earlier intervals.
Conclusions:
- Atherosclerotic occlusive disease (AOD) progression is a frequent occurrence in patients requiring lower extremity revascularization.
- Progression is more prevalent following femoropopliteal bypass compared to suprainguinal bypass.
- Arterial reconstruction for AOD does not appear to exacerbate disease progression, which is linked to the underlying disease pattern.
Purpose:
The characteristics of progression of atherosclerotic occlusive disease (AOD) of the lower extremities after revascularization are unknown. Duplex scanning or angiography were used to determine progression in 150 patients after they underwent revascularization for AOD.
Methods:
Follow-up studies were compared with presurgical arteriograms. Superficial femoral (SFA) and popliteal arteries were graded as less than 50% stenosis, 50% to 99% stenosis, or occluded. Tibial arteries were graded with regard to whether they were continuously patent from the popliteal trifurcation to the ankle. Progression was defined as an increase in one stenosis category.
Results:
At a mean follow-up of 4.8 years, 18% of native arteries, 39% of extremities, and 52% of patients demonstrated progression of AOD. Overall, 21% of arteries in patients undergoing infrainguinal bypass and 14% of arteries in patients undergoing suprainguinal bypass demonstrated progression (p = 0.004). Progression was more frequently detected in examinations performed more than 4 years after baseline arteriography (66%) than in examinations performed 6 months to 2 years (45%, p = 0.032) or 2 to 4 years (44%, p = 0.029) after baseline arteriography. Thirty percent of SFAs demonstrated progression, and 32% with 50% stenosis or greater at baseline became occluded. There was no difference in SFA, popliteal, or tibial artery progression in revascularized versus nonrevascularized extremities after suprainguinal bypass. There was no difference in tibial artery progression in operated and nonoperated limbs after femoropopliteal artery bypass.
Conclusions:
AOD progression occurs frequently in patients requiring revascularization and is more prevalent in patients requiring femoropopliteal than in patients requiring suprainguinal bypass. AOD progression in patients undergoing vascular surgery is associated with the pattern of disease producing lower extremity ischemia and does not appear to be worsened by arterial reconstruction.
More Related Videos
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
13:48Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
Published on: April 21, 2023
Related Concept Videos
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:23Atherosclerosis IV: Nursing Management
01:30Peripheral Artery Disease I: Introduction
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:27Peripheral Artery Disease III: Interprofessional Care
01:23Peripheral Artery Disease V: Postoperative Nursing Management