AI Occlusive Disease: A Case Study
Embolism
Two well-recognized exceptions to the general observationthat isolated AI occlusive disease does not result in CLI arisein the context of embolic disease. Large thrombo-emboli thatarise from a cardiac or other proximal source and lodge at theaortic bifurcation, referred to as saddle emboli, can lead toprofound acute bilateral lower extremity ischemia (blue toe syndrome).(Wingo et al, 1986)
In contrast, occurs when atheroscleroticdebris breaks free from an aortic or iliac plaque andembolizes to the distal vessels. Wire manipulation duringcoronary or peripheral angiographic procedures or surgicalcross-clamping across a calcific aortic plaque can trigger suchemboli. The terminal targets of the microembolic particlescomposed of cholesterol …show more content…
Epidemiology
The majority of patients presenting with atheroscleroticocclusive disease of the aorta and iliac vessels have diffusedisease involving multiple levels of the peripheral vasculaturetree; in most cases, AI occlusive disease is found in combinationwith femoropopliteal or infrageniculate occlusive disease.
Patients with isolated AI disease are generally younger andhave a higher relative incidence of smoking and hypercholesterolemiaas associated vascular risk factors. They arenearly as likely to be female as male and typically have anormal life expectancy.(Malone et al, 1977)
In contrast to this pattern, patientswith more progressive multilevel disease are commonly older;more frequently have diabetes and hypertension and aremore likely to be male and to have concomitant cerebrovascular,coronary, and visceral atherosclerosis.(Darling et al, 1979)
Not surprisingly,patients with diffuse, multisegment disease oftenpresent with ischemic rest pain or more severe perfusionimpairment, leading to tissue loss or gangrene as opposed toisolated claudication. Such patients manifest a significantreduction in life expectancy compared with their age-matchedcounterparts.(Brewster et al,
Two well-recognized exceptions to the general observationthat isolated AI occlusive disease does not result in CLI arisein the context of embolic disease. Large thrombo-emboli thatarise from a cardiac or other proximal source and lodge at theaortic bifurcation, referred to as saddle emboli, can lead toprofound acute bilateral lower extremity ischemia (blue toe syndrome).(Wingo et al, 1986)
In contrast, occurs when atheroscleroticdebris breaks free from an aortic or iliac plaque andembolizes to the distal vessels. Wire manipulation duringcoronary or peripheral angiographic procedures or surgicalcross-clamping across a calcific aortic plaque can trigger suchemboli. The terminal targets of the microembolic particlescomposed of cholesterol …show more content…
Epidemiology
The majority of patients presenting with atheroscleroticocclusive disease of the aorta and iliac vessels have diffusedisease involving multiple levels of the peripheral vasculaturetree; in most cases, AI occlusive disease is found in combinationwith femoropopliteal or infrageniculate occlusive disease.
Patients with isolated AI disease are generally younger andhave a higher relative incidence of smoking and hypercholesterolemiaas associated vascular risk factors. They arenearly as likely to be female as male and typically have anormal life expectancy.(Malone et al, 1977)
In contrast to this pattern, patientswith more progressive multilevel disease are commonly older;more frequently have diabetes and hypertension and aremore likely to be male and to have concomitant cerebrovascular,coronary, and visceral atherosclerosis.(Darling et al, 1979)
Not surprisingly,patients with diffuse, multisegment disease oftenpresent with ischemic rest pain or more severe perfusionimpairment, leading to tissue loss or gangrene as opposed toisolated claudication. Such patients manifest a significantreduction in life expectancy compared with their age-matchedcounterparts.(Brewster et al,