Application Of CTA To Study The Factors Influencing The Establishment Of Collateral Circulation In Patients With Symptomatic Superficial Femoral Artery Occlusion

ObjectivePatients with symptomatic superficial femoral artery occlusion were studied to investigate the influencing factors related to the formation of superficial femoral artery collateral circulation by analyzing clinical data and CT angiography(CTA)features.MethodsA total of 152 patients admitted to the vascular surgery department of our hospital from October 2017 to October 2022 for lower extremity artery CTA examination with superficial femoral artery occlusion,slight or lower popliteal artery stenosis,and at least one lower leg artery occlusion were selected and grouped by the number and size of contralateral vessels using the established scoring system.According to the number of collateral vessels,they were divided into 0-3 collateral vessels,4-7 collateral vessels and ≥ 8 collateral vessels.According to the size of collateral vessels,it is divided into grade 1: ≤5 small vessels;Grade 2: > 5 small blood vessels;Grade 3: ≤5 large vessels;Grade 4: > 5 large vessels.Comparisons between groups were made using independent samples t-test,One-Way ANOVA,Chi-square(χ~2)test and rank sum test.Multiple factors were analyzed by logistic regression.The general clinical data of the patients(such as gender,age),previous medical history(such as hypertension,diabetes mellitus,etc.)were analyzed in relation to the number and size of side branches in patients with superficial femoral artery occlusion.ResultsUnivariate analysis showed statistically significant differences in history of diabetes,history of smoking and duration of symptoms between the 3 groups of vascular counts(P<0.05);There were no statistically significant differences when comparing the sex ratio,age,BMI,blood pressure status,cardiovascular and cerebrovascular history,and alcohol consumption(P>0.05).The differences between the small lateral branch group and the large lateral branch group were statistically significant in terms of gender,history of diabetes,history of smoking and duration of symptoms(P<0.05);The differences were not statistically significant when comparing age,BMI,blood pressure status,cardiovascular history and alcohol consumption(P>0.05).The variables that were statistically significant(P<0.05)in the univariate analysis were brought into the multivariate logistic regression analysis equation,and the results showed that diabetes mellitus and duration of symptoms were independent influences on the number and size of collateral vessels in patients with symptomatic SFA occlusion.Conclusion1.In patients with symptomatic superficial femoral artery occlusion,diabetes mellitus and the duration of symptoms are independent influences on the number and size of the collateral circulation in the superficial femoral artery.The longer the duration of symptoms,the more pronounced the collateral circulation.And diabetes has an inhibitory effect on the establishment and development of collateral circulation.2.The influence of hypertension,alcohol consumption,age,and history of cardiovascular and cerebrovascular diseases on posterior collateral circulation of superficial femoral artery occlusion is not obvious.3.The evaluation of collateral circulation by CTA can provide important reference values for clinical diagnosis,treatment and follow-up.