Bilateral Peripheral Arterial Disease in an Elderly.

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
Bilateral Peripheral Arterial
Disease in an Elderly Man
Prof. Abdulsalam Y Taha
College of Medicine
University of Sulaimani
2022 1

2. The Case
 Herein, we present a few angiographic
pictures obtained from a short movie
of conventional abdominal aortography
and bilateral femoral arteriography
performed via the femoral approach in
a man of 89. Unfortunately, the
clinical data were not available.
However, the angiography revealed
bilateral superficial femoral artery
occlusions. 2

3. Abdominal aortography and
bilateral femoral arteriography
3
Courtesy of Prof. Abdulsalam Y Taha

4. Left superficial femoral
artery (SFA) occlusion
4
Courtesy of Prof. Abdulsalam Y Taha

5. Abundant collaterals due to the
chronicity of the arterial occlusion
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Courtesy of Prof. Abdulsalam Y Taha

6. Right SFA occlusion
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Courtesy of Prof. Abdulsalam Y Taha

7. Comment
 “Peripheral arterial disease (PAD) is
chronic arterial occlusive disease of
the lower extremities caused by
atherosclerosis. PAD may cause
intermittent claudication which is pain
or weakness with walking that is
relieved with rest. The muscle pain or
weakness after exercise occurs distal
to the arterial obstruction” [1].
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8. Comment…
 “Since the superficial femoral and
popliteal arteries are most
commonly affected by
atherosclerosis, the pain of
intermittent claudication is most
commonly localized to the calf.
Atherosclerotic obstruction of the
distal aorta and its bifurcation into
the two iliac arteries may cause
pain in the buttocks, hips, thighs, or
the inferior back muscles as well as
the calves ” [1]. 8

9. Comment…
 “Angiography is the criterion standard
arterial imaging study for the diagnosis of
PAD. SFA occlusion is the most common area
for PAD” [2].
 The angiographic criteria for a bypass
arterial surgery are patent inflow vessels,
segmental occlusion and patent distal run
off vessels. In the case presented herein,
the distal runoff vessels were very poor,
thus a bypass arterial surgery would not be
possible, leaving the case for medical
therapies alone.
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10. ● Bibliography
[1] Aronow WS. Peripheral arterial disease in the
elderly. Clin Interv Aging. 2007;2(4):645-54. doi:
10.2147/cia.s2412. PMID: 18225466; PMCID:
PMC2686340.
[2]
https://emedicine.medscape.com/article/46017
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