SEVERE VASCULAR CALCIFICATION IN PERIPHERAL ARTERIAL DISEASE: IS THERE A LIMIT TO REVASCULARIZATION?

  • Daniel Mendes Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Rui Machado Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto; Instituto de Ciências Biomédicas Abel Salazar – Universidade do Porto
  • Vitor Ferreira Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • João Gonçalves Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Gabriela Teixeira Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Inês Antunes Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Carlos Veiga Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Carlos Veterano Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto
  • Rui de Almeida Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar Universitário do Porto; Instituto de Ciências Biomédicas Abel Salazar – Universidade do Porto
Keywords: Calcificação vascular, bypass periférico, diabetes mellitus, doença renal crónica

Abstract

Vascular calcification is associated with a worsening of the ischemia categories in patients with peripheral arterial disease independently and represents a huge challenge in both endovascular treatment and revascularization surgery. We present a case report of a patient with multiple cardiovascular risk factors and with risk factors for calcification (diabetes and chronic kidney disease), with critical ischemia, adequately treated with a popliteal-pedous bypass.

Downloads

Download data is not yet available.

References

1. Rocha-Singh, K.J., T. Zeller, and M.R. Jaff, Peripheral arterial calcification:
prevalence, mechanism, detection, and clinical implications.
Catheter Cardiovasc Interv, 2014. 83(6): p. E212-20.
2. Albanese, I., et al., Atherosclerotic Calcification: Wnt Is the Hint. J
Am Heart Assoc, 2018. 7(4).
3. Allison, M.A., M.H. Criqui, and C.M. Wright, Patterns and risk factors
for systemic calcified atherosclerosis. Arterioscler Thromb Vasc
Biol, 2004. 24(2): p. 331-6.
4. Ho, C.Y. and C.M. Shanahan, Medial Arterial Calcification: An Overlooked
Player in Peripheral Arterial Disease. Arterioscler Thromb
Vasc Biol, 2016. 36(8): p. 1475-82.
5. Prasad, R., et al., Non-healing ulcer of right foot due to Monckeberg's
arteriosclerosis. BMJ Case Rep, 2015. 2015.
6. Zettervall, S.L., et al., Association of arterial calcification with
chronic limb ischemia in patients with peripheral artery disease.
J Vasc Surg, 2018. 67(2): p. 507-513.
7. Ferraresi, R., et al., Long-term outcomes after angioplasty of isolated,
below-the-knee arteries in diabetic patients with critical limb
ischaemia. Eur J Vasc Endovasc Surg, 2009. 37(3): p. 336-42.
8. Karmody, A.M., et al., Peroneal artery bypass: a reappraisal of its
value in limb salvage. J Vasc Surg, 1984. 1(6): p. 809-16.
9. Christensen, N.J., Muscle blood flow, measured by and vascular
calcifications in diabetics. Acta Med Scand, 1968. 183(5): p. 449-54.
10. Ballotta, E., et al., Patency and limb salvage rates after distal
revascularization to unclampable calcified outflow arteries. J Vasc
Surg, 2004. 39(3): p. 539-46.
Published
2018-06-07
Section
Vascular Image

Most read articles by the same author(s)