title: Retrospective angiographic study to determine the effect of atherosclerotic stenoses of upstream arteries on the degree of atherosclerosis in distal vascular territories.
abstract: Experimental coarctation of the aorta prevents the development of downstream atherosclerosis. The aim of this study was to find out whether or not atherosclerotic stenoses protect distal vascular territories from developing atherosclerosis in humans.
  
  
  
  A total of 2125 vascular segments from angiographies of 101 patients were evaluated by calculating the maximum degree of stenosis (NASCET criteria), the degree of calcification, the degree of collaterals and the Friesinger score.
  
  
  
  Stenosis ≥30-49% was found in 685 vascular segments (32.2%), ≥50-69% in 490 (23.1%), ≥70-89% in 373 (17.6%) and ≥90% in 265 (12.5%). If a stenosis of at least ≥70-89% was present in the common iliac, the external iliac or the common femoral artery, the degrees of stenosis distal to it were lower than those on the contralateral side (19.8±22.3% (CI 11.7 to 28.0) vs 25.2±20.7% (CI 21.2 to 29.1); Friesinger scores 1.1±1.2 (CI 0.6 to 1.5) vs 1.4±1.1 (CI 1.2 to 1.6); degrees of calcification 0.8±1.0 (CI 0.4 to 1.1) vs 1.2±1.1 (CI 1.2 to 1.6); p<0.05 each). This effect depended on the degree of proximal stenosis, but not on collaterals, and was most pronounced distal to stenoses of the common iliac, the superficial femoral and the popliteal artery. In regression models, stenoses of the pelvic arteries were shown to be an independent protective factor for the distal vascular territories.
  
  
  
  Atherosclerotic stenoses seem to protect distal vascular territories from developing atherosclerosis. The underlying pathophysiological mechanism of this phenomenon remains to be determined. It could be based on pulse pressure reduction.
authors.affiliation: Department of Radiology, University Hospital for Radiology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rehwald
authors.affiliation: Department of Radiology, University Hospital for Radiology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Petersen
authors.affiliation: Department of Surgery, University Hospital for Vascular Surgery, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gratl
authors.affiliation: Department of Internal Medicine, University Hospital for Internal Medicine II, Gastroenterology and Hepatology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Zoller
authors.affiliation: Department of Radiology, University Hospital for Radiology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mader
authors.affiliation: Department of Radiology, University Hospital for Radiology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Loizides
authors.affiliation: Department of Radiology, University Hospital for Neuroradiology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Astrid E
authors.initials: AE
authors.lastname: Grams
authors.affiliation: Department of Internal Medicine, University Hospital for Internal Medicine II, Gastroenterology and Hepatology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Klocker
authors.affiliation: Department of Radiology, University Hospital for Radiology, Medical University of Innsbruck, Innsbruck, Tyrol, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Glodny
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001317:Austria; D001794:Blood Pressure; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D007083:Iliac Artery / Q000473:pathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply; D065840:Protective Factors; D012189:Retrospective Studies
keywords: RADIOLOGY & IMAGING; arteriosclerosis; peripheral arterial disease; risk factors