An angiographic analysis of atherosclerosis progression in below-the-knee arteries after femoropopliteal angioplasty in claudicants

J Endovasc Ther. 2010 Feb;17(1):39-45. doi: 10.1583/09-2819.1.


Purpose: To report an angiographic investigation of midterm atherosclerotic disease progression in below-the-knee (BTK) arteries of claudicants.

Methods: Angiograms were performed in 58 consecutive claudicants (35 men; mean age 68.3+/-8.7 years) with endovascular treatment of femoropopliteal arteries in 58 limbs after a mean follow-up of 3.6+/-1.2 years. Angiograms were reviewed in consensus by 2 experienced readers blinded to clinical data. Progression of atherosclerosis in 4 BTK arterial segments (tibioperoneal trunk, anterior and posterior tibial arteries, and peroneal artery) was assessed according to the Bollinger score. The composite per calf Bollinger score represented the average of the 4 BTK arterial segment scores. The association of the Bollinger score with cardiovascular risk factors and gender was scrutinized.

Results: A statistically significant increase in atherosclerotic burden was observed for the mean composite per calf Bollinger score (5.7+/-8.3 increase, 95% CI 3.5 to 7.9, p<0.0001), as well as for each single arterial segment analyzed. In multivariate linear regression analysis, diabetes mellitus was associated with a more pronounced progression of atherosclerotic burden in crural arteries (beta: 5.6, p = 0.035, 95% CI 0.398 to 10.806).

Conclusion: Progression of infrapopliteal atherosclerotic lesions is common in claudicants during midterm follow-up. Presence of diabetes mellitus was confirmed as a major risk factor for more pronounced atherosclerotic BTK disease progression.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Angiography, Digital Subtraction*
  • Angioplasty, Balloon*
  • Atherosclerosis / complications
  • Atherosclerosis / diagnostic imaging*
  • Atherosclerosis / therapy*
  • Brachytherapy
  • Constriction, Pathologic
  • Disease Progression
  • Female
  • Femoral Artery / diagnostic imaging*
  • Humans
  • Intermittent Claudication / diagnostic imaging*
  • Intermittent Claudication / etiology
  • Intermittent Claudication / therapy*
  • Knee / blood supply*
  • Linear Models
  • Male
  • Middle Aged
  • Popliteal Artery / diagnostic imaging*
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Tibial Arteries / diagnostic imaging
  • Time Factors
  • Treatment Outcome