Prevalence of visceral artery involvement in patients with peripheral artery disease found on run-off MRA

Abstract

Background In patients with peripheral artery disease (PAD), run-off MR-angiography (MRA) is a commonly performed diagnostic test to obtain high-resolution images for evaluation of the arterial system from the aorta through the distal run-off vessels. The aim of this study was to investigate the prevalence of visceral artery involvement (VAI) in patients with PAD and leg symptoms examined with run-off MRA. Methods We retrospectively analyzed 145 patients (median age 68 years, range 27–91) who underwent MRA due to known or suspected PAD at our institution between 2012 and 2018. MRA examinations were re-evaluated for visceral artery stenosis. Patient dossiers were reviewed to determine cardiovascular risk factors, kidney function and Fontaine stage of PAD. Results Involvement of at least one visceral artery with ≥ 50% diameter stenosis was found in 72 (50%) patients. There were no differences in age, gender, MRA indication, Fontaine stage, levels of C-reactive protein (CRP), cardiovascular risk factors or vascular comorbidities between patients with and without VAI. Renal artery (RA) involvement with ≥ 50% diameter stenosis was observed in 28 (20%) of patients. Patients with involvement of the RA were more likely to suffer from hypertension (79 vs. 54%, p = 0.019) and reduced renal function (glomerular filtration rate 70 vs. 88 mL/min/1.73m2, p = 0.014). Conclusion Visceral artery stenosis can be seen in half of patients with known or suspected PAD and leg symptoms on run-off MRA. Investigating for RA stenosis in patients with PAD and hypertension and/or impaired renal function may have high diagnostic yield.

Diagnostic and Treatment Algorithm in a Plurivascular Patient – Case Report

“…Another study revealed that visceral artery stenosis may coexist in almost 50% of patients with peripheral artery disease. 6 Both symptomatic subclavian artery stenosis and stenosis above 50% of the carotid artery associated with symptoms have indication for interventional treatment, 1 which also represented the first step in the management of our patient. Of particular importance is that peripheral arterial occlusive disease associated with coronary or cerebrovascular disease significantly increases the risk of mortality caused by cardiovascular or cerebrovascular events.…”

Visceral and Ectopic Abdominal Fat Effect on the Calcification of the Abdominal Aorta and Its Branches—An MSCT Study

“…Several published studies investigated calcifications of the abdominal aorta and its branches with inconclusive results [18][19][20], and the clear effect of the visceral and ectopic fat on abdominopelvic arteries remained under investigated. We think that the non-contrast multislice CT (MSCT) scan of the abdomen and pelvis can reveal the associations of fat tissue accumulation and the atherosclerotic calcifications of abdominopelvic arteries.…”

Outcomes of Hospitalized Patients Undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP) With and Without a History of Peripheral Artery Disease

“…PAD is associated with other atherosclerotic syndromes, including chronic mesenteric ischemia and stenosis of other arteries that supply visceral organs [13]. We hypothesize that in patients with PAD who are predisposed to atherosclerosis, endothelial dysfunction of vessels supplying the biliary system can potentially impair post-procedural healing, thereby predisposing one to complications such as bleeding, infection, and perforation after trauma caused by ERCP.…”