The distribution of calcified nodule and plaque rupture in patients with peripheral artery disease: an intravascular ultrasound analysis.
In addition to plaque rupture (PR), calcified nodule (CN) may also have the potential to develop into arterial thrombus in the peripheral arteries. This study evaluated the distribution of plaque ruptures and calcified nodules in the peripheral arteries and their impact on the outcome of endovascular therapy (EVT). Consecutive 159 patients who underwent EVT with intravascular ultrasound guidance were enrolled. The position of CNs and PRs were assigned to any of common iliac artery, external iliac artery, common femoral artery, and superficial femoral artery. Forty-six (29%) patients had calcified nodule and twenty-eight (18%) patients had plaque rupture somewhere in the lower limb arteries. Although calcified nodules were evenly distributed throughout the length of the arteries plaque ruptures were predominantly located in the proximal segment of the iliofemoral arteries. Stent expansion ratio was significantly smaller in the target arteries with calcified nodules than in those with plaque rupture. Multivariate logistic regression analysis identified hemodialysis as an independent clinical predictor of calcified nodule (odds ratio 8.15, 95% confidence interval 1.73-38.3; P = 0.008). CN definitely affects incomplete stent deployment in the peripheral artery contributing to adverse events, on the other hand, PR has more acceptable outcomes after stent implantation. In the clinical setting, it is important that we realize the features of peripheral artery disease and its patient characteristics which having CNs and PRs to make a strategy for revascularization.
['Horimatsu|Tetsuo|T|', 'Fujii|Kenichi|K|', 'Fukunaga|Masashi|M|', 'Miki|Kojiro|K|', 'Nishimura|Machiko|M|', 'Naito|Yoshiro|Y|', 'Shibuya|Masahiko|M|', 'Imanaka|Takahiro|T|', 'Kawai|Kenji|K|', 'Tamaru|Hiroto|H|', 'Sumiyoshi|Akinori|A|', 'Saita|Ten|T|', 'Masuyama|Tohru|T|', 'Ishihara|Masaharu|M|']
D000368:Aged D000369:Aged, 80 and over D002114:Calcinosis D005260:Female D005263:Femoral Artery D006801:Humans D007083:Iliac Artery D007564:Japan D016015:Logistic Models D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D058729:Peripheral Arterial Disease D058226:Plaque, Atherosclerotic D011446:Prospective Studies D012422:Rupture, Spontaneous D015607:Stents D018084:Ultrasonography, Interventional
Calcified nodule Plaque rupture Peripheral artery disease