Peripheral vascular disease: who gets it and why? A histomorphological analysis of 261 arterial segments from 58 cases
This retrospective study aimed to document and illustrate the histomorphological changes underlying peripheral vascular disease (PVD). More specifically, it aimed to analyse and quantify those changes that lead to lower limb amputations. Histological changes were assessed in relation to various clin...
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| Veröffentlicht in: | Pathology 2008-06, Vol.40 (4), p.385-391 |
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| creator | Soor, Gursharan S. Vukin, Iva Leong, Shaun W. Oreopoulos, George Butany, Jagdish |
| description | This retrospective study aimed to document and illustrate the histomorphological changes underlying peripheral vascular disease (PVD). More specifically, it aimed to analyse and quantify those changes that lead to lower limb amputations. Histological changes were assessed in relation to various clinical pathologies, and significant correlations were sought thereafter
A total of 1305 arterial segments were examined from 58 consecutive patients undergoing a lower limb amputation from January 2002 to December 2003. Serial arterial segments were taken from the femoral, popliteal, anterior tibial, posterior tibial, peroneal, and dorsalis pedis arteries, and the degrees of atherosclerotic stenosis and medial calcification were histologically quantified.
Atherosclerosis was associated with severe arterial stenosis. An increased occurrence of severe atherosclerotic narrowing coincided with increasing patient age (p=0.0166), hypertension (p=0.0019), and diabetes mellitus (p=0.0036). The presence of medial calcification was an important pathological feature in patients under 70 years of age (p=0.0308) and significantly more severe in those with diabetes mellitus (p |
| doi_str_mv | 10.1080/00313020802036764 |
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A total of 1305 arterial segments were examined from 58 consecutive patients undergoing a lower limb amputation from January 2002 to December 2003. Serial arterial segments were taken from the femoral, popliteal, anterior tibial, posterior tibial, peroneal, and dorsalis pedis arteries, and the degrees of atherosclerotic stenosis and medial calcification were histologically quantified.
Atherosclerosis was associated with severe arterial stenosis. An increased occurrence of severe atherosclerotic narrowing coincided with increasing patient age (p=0.0166), hypertension (p=0.0019), and diabetes mellitus (p=0.0036). The presence of medial calcification was an important pathological feature in patients under 70 years of age (p=0.0308) and significantly more severe in those with diabetes mellitus (p<0.001).
Atherosclerosis and medial calcification are significant underlying lesions in diabetic patients undergoing lower limb amputation. Medial calcification can cause significant stiffening of the arterial wall and a reduction in its ability to respond to vasodilator stimuli.</description><identifier>ISSN: 0031-3025</identifier><identifier>EISSN: 1465-3931</identifier><identifier>DOI: 10.1080/00313020802036764</identifier><identifier>PMID: 18446629</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Amputation ; Arteries - pathology ; atherosclerosis ; Atherosclerosis - complications ; Atherosclerosis - metabolism ; Atherosclerosis - pathology ; Calcinosis - metabolism ; Calcinosis - pathology ; chronic total occlusion ; Constriction, Pathologic - etiology ; Constriction, Pathologic - metabolism ; Constriction, Pathologic - pathology ; diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - pathology ; Diabetic Angiopathies - complications ; Diabetic Angiopathies - pathology ; Female ; Humans ; ischaemia ; Ischemia - pathology ; Leg - blood supply ; Lower limb amputations ; Male ; medial calcification ; Middle Aged ; Peripheral Vascular Diseases - etiology ; Peripheral Vascular Diseases - metabolism ; Peripheral Vascular Diseases - pathology ; Retrospective Studies ; Tunica Media - metabolism ; Tunica Media - pathology</subject><ispartof>Pathology, 2008-06, Vol.40 (4), p.385-391</ispartof><rights>2008 Royal College of Pathologists of Australasia</rights><rights>2008 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-e2af5e856569f0c0d0b660438d20f118b07fa6d633d98c250223150f3c98af1f3</citedby><cites>FETCH-LOGICAL-c403t-e2af5e856569f0c0d0b660438d20f118b07fa6d633d98c250223150f3c98af1f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/00313020802036764$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/00313020802036764$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,61197,61378</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18446629$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soor, Gursharan S.</creatorcontrib><creatorcontrib>Vukin, Iva</creatorcontrib><creatorcontrib>Leong, Shaun W.</creatorcontrib><creatorcontrib>Oreopoulos, George</creatorcontrib><creatorcontrib>Butany, Jagdish</creatorcontrib><title>Peripheral vascular disease: who gets it and why? A histomorphological analysis of 261 arterial segments from 58 cases</title><title>Pathology</title><addtitle>Pathology</addtitle><description>This retrospective study aimed to document and illustrate the histomorphological changes underlying peripheral vascular disease (PVD). More specifically, it aimed to analyse and quantify those changes that lead to lower limb amputations. Histological changes were assessed in relation to various clinical pathologies, and significant correlations were sought thereafter
A total of 1305 arterial segments were examined from 58 consecutive patients undergoing a lower limb amputation from January 2002 to December 2003. Serial arterial segments were taken from the femoral, popliteal, anterior tibial, posterior tibial, peroneal, and dorsalis pedis arteries, and the degrees of atherosclerotic stenosis and medial calcification were histologically quantified.
Atherosclerosis was associated with severe arterial stenosis. An increased occurrence of severe atherosclerotic narrowing coincided with increasing patient age (p=0.0166), hypertension (p=0.0019), and diabetes mellitus (p=0.0036). The presence of medial calcification was an important pathological feature in patients under 70 years of age (p=0.0308) and significantly more severe in those with diabetes mellitus (p<0.001).
Atherosclerosis and medial calcification are significant underlying lesions in diabetic patients undergoing lower limb amputation. Medial calcification can cause significant stiffening of the arterial wall and a reduction in its ability to respond to vasodilator stimuli.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amputation</subject><subject>Arteries - pathology</subject><subject>atherosclerosis</subject><subject>Atherosclerosis - complications</subject><subject>Atherosclerosis - metabolism</subject><subject>Atherosclerosis - pathology</subject><subject>Calcinosis - metabolism</subject><subject>Calcinosis - pathology</subject><subject>chronic total occlusion</subject><subject>Constriction, Pathologic - etiology</subject><subject>Constriction, Pathologic - metabolism</subject><subject>Constriction, Pathologic - pathology</subject><subject>diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - pathology</subject><subject>Diabetic Angiopathies - complications</subject><subject>Diabetic Angiopathies - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>ischaemia</subject><subject>Ischemia - pathology</subject><subject>Leg - blood supply</subject><subject>Lower limb amputations</subject><subject>Male</subject><subject>medial calcification</subject><subject>Middle Aged</subject><subject>Peripheral Vascular Diseases - etiology</subject><subject>Peripheral Vascular Diseases - metabolism</subject><subject>Peripheral Vascular Diseases - pathology</subject><subject>Retrospective Studies</subject><subject>Tunica Media - metabolism</subject><subject>Tunica Media - pathology</subject><issn>0031-3025</issn><issn>1465-3931</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi0EokvhB3BBPnELjO3YdeCAqoovqRIc4Gx5nfHGVRIvnmSr_fe42pU4IPU0M5r3eQ4vY68FvBNg4T2AEgpkXSUoc2XaJ2wjWqMb1SnxlG0e_k0N6Av2gugOAFpr7XN2IWzbGiO7DTv8xJL2AxY_8oOnsI6-8D4ResIP_H7IfIcL8bRwP_f1Pn7i13xItOQpl_2Qx7xLobJ-9uOREvEcuTSC-7JUcX0Q7iacqyKWPHFteahmesmeRT8SvjrPS_b7y-dfN9-a2x9fv99c3zahBbU0KH3UaLXRposQoIetMdAq20uIQtgtXEVveqNU39kgNUiphIaoQmd9FFFdsrcn777kPyvS4qZEAcfRz5hXcqYTWkuhalCcgqFkooLR7UuafDk6Ae6hbPdf2ZV5c5av2wn7f8S53Rr4eAqkOeYy-QH9uAzBF3R3eS21MnpUf6axFnRIWByFhHPAPhUMi-tzeoT-C8_InhM</recordid><startdate>200806</startdate><enddate>200806</enddate><creator>Soor, Gursharan S.</creator><creator>Vukin, Iva</creator><creator>Leong, Shaun W.</creator><creator>Oreopoulos, George</creator><creator>Butany, Jagdish</creator><general>Elsevier B.V</general><general>Informa UK Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200806</creationdate><title>Peripheral vascular disease: who gets it and why? A histomorphological analysis of 261 arterial segments from 58 cases</title><author>Soor, Gursharan S. ; Vukin, Iva ; Leong, Shaun W. ; Oreopoulos, George ; Butany, Jagdish</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-e2af5e856569f0c0d0b660438d20f118b07fa6d633d98c250223150f3c98af1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amputation</topic><topic>Arteries - pathology</topic><topic>atherosclerosis</topic><topic>Atherosclerosis - complications</topic><topic>Atherosclerosis - metabolism</topic><topic>Atherosclerosis - pathology</topic><topic>Calcinosis - metabolism</topic><topic>Calcinosis - pathology</topic><topic>chronic total occlusion</topic><topic>Constriction, Pathologic - etiology</topic><topic>Constriction, Pathologic - metabolism</topic><topic>Constriction, Pathologic - pathology</topic><topic>diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - pathology</topic><topic>Diabetic Angiopathies - complications</topic><topic>Diabetic Angiopathies - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>ischaemia</topic><topic>Ischemia - pathology</topic><topic>Leg - blood supply</topic><topic>Lower limb amputations</topic><topic>Male</topic><topic>medial calcification</topic><topic>Middle Aged</topic><topic>Peripheral Vascular Diseases - etiology</topic><topic>Peripheral Vascular Diseases - metabolism</topic><topic>Peripheral Vascular Diseases - pathology</topic><topic>Retrospective Studies</topic><topic>Tunica Media - metabolism</topic><topic>Tunica Media - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soor, Gursharan S.</creatorcontrib><creatorcontrib>Vukin, Iva</creatorcontrib><creatorcontrib>Leong, Shaun W.</creatorcontrib><creatorcontrib>Oreopoulos, George</creatorcontrib><creatorcontrib>Butany, Jagdish</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soor, Gursharan S.</au><au>Vukin, Iva</au><au>Leong, Shaun W.</au><au>Oreopoulos, George</au><au>Butany, Jagdish</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Peripheral vascular disease: who gets it and why? A histomorphological analysis of 261 arterial segments from 58 cases</atitle><jtitle>Pathology</jtitle><addtitle>Pathology</addtitle><date>2008-06</date><risdate>2008</risdate><volume>40</volume><issue>4</issue><spage>385</spage><epage>391</epage><pages>385-391</pages><issn>0031-3025</issn><eissn>1465-3931</eissn><abstract>This retrospective study aimed to document and illustrate the histomorphological changes underlying peripheral vascular disease (PVD). More specifically, it aimed to analyse and quantify those changes that lead to lower limb amputations. Histological changes were assessed in relation to various clinical pathologies, and significant correlations were sought thereafter
A total of 1305 arterial segments were examined from 58 consecutive patients undergoing a lower limb amputation from January 2002 to December 2003. Serial arterial segments were taken from the femoral, popliteal, anterior tibial, posterior tibial, peroneal, and dorsalis pedis arteries, and the degrees of atherosclerotic stenosis and medial calcification were histologically quantified.
Atherosclerosis was associated with severe arterial stenosis. An increased occurrence of severe atherosclerotic narrowing coincided with increasing patient age (p=0.0166), hypertension (p=0.0019), and diabetes mellitus (p=0.0036). The presence of medial calcification was an important pathological feature in patients under 70 years of age (p=0.0308) and significantly more severe in those with diabetes mellitus (p<0.001).
Atherosclerosis and medial calcification are significant underlying lesions in diabetic patients undergoing lower limb amputation. Medial calcification can cause significant stiffening of the arterial wall and a reduction in its ability to respond to vasodilator stimuli.</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>18446629</pmid><doi>10.1080/00313020802036764</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Amputation Arteries - pathology atherosclerosis Atherosclerosis - complications Atherosclerosis - metabolism Atherosclerosis - pathology Calcinosis - metabolism Calcinosis - pathology chronic total occlusion Constriction, Pathologic - etiology Constriction, Pathologic - metabolism Constriction, Pathologic - pathology diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - pathology Diabetic Angiopathies - complications Diabetic Angiopathies - pathology Female Humans ischaemia Ischemia - pathology Leg - blood supply Lower limb amputations Male medial calcification Middle Aged Peripheral Vascular Diseases - etiology Peripheral Vascular Diseases - metabolism Peripheral Vascular Diseases - pathology Retrospective Studies Tunica Media - metabolism Tunica Media - pathology |
| title | Peripheral vascular disease: who gets it and why? A histomorphological analysis of 261 arterial segments from 58 cases |
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