%0 Journal Article
%T Pathological Analysis of Medial and Intimal Calcification in Lower Extremity Artery Disease: Impact of Hemodialysis.
%A Kato T
%A Torii S
%A Nakamura N
%A Aihara K
%A Terabe Y
%A Iida O
%A Tokuda T
%A Nakama T
%A Kawahara Y
%A Miyamoto J
%A Saito T
%A Kamioka N
%A Murakami T
%A Ijichi T
%A Natsumeda M
%A Tanaka S
%A Ohno Y
%A Nakazawa G
%A Watanabe H
%A Ikari Y
%J JACC Adv
%V 2
%N 9
%D 2023 Nov
%M 38938733
暂无%R 10.1016/j.jacadv.2023.100656
%X <B>UNASSIGNED: </B>The prevalence and degree of lower extremity artery disease in hemodialysis (HD) patients is higher than in the general population. However, the pathological features have not yet been evaluated.<BR><B>UNASSIGNED: </B>The aim of the study was: 1) to compare lesion characteristics of lower extremity artery disease in HD vs non-HD patients; and 2) to determine factors associated with severe medial calcification.<BR><B>UNASSIGNED: </B>Seventy-seven lower limb arteries were assessed from 36 patients (median age 77 years; 23 men; 21 HD and 15 non-HD) who underwent autopsy or lower limb amputation. Arteries were serially cut at 3- to 4-mm intervals creating 2,319 histological sections. Morphometric analysis and calcification measurements were performed using ZEN software. Calcification with a circumferential angle (arc) ≥180° was defined as severe calcification. Multivariable logistic regression was used to identify risk factors for severe medial calcification.<BR><B>UNASSIGNED: </B>The degree of the medial calcification arc was significantly higher in the HD group compared to the non-HD group (P < 0.0001). In the multivariable analysis, HD was associated with severe medial calcification in below-the-knee lesions (OR: 17.1; P = 0.02). The degree of intimal calcification in above-the-knee lesions was also significantly higher in HD patients with a higher prevalence of advanced atherosclerotic plaque (P = 0.02). The prevalence of severe bone formation was more common in the HD patients (P = 0.01).<BR><B>UNASSIGNED: </B>Hemodialysis patients demonstrated a higher degree of medial and intimal calcification compared with non-HD patients. The difference was more prominent in the medial calcification of below-the-knee lesions.