TY - JOUR
T1 - The association between peripheral artery and lumbar spine disease
T2 - A Single-center Study
AU - Ain, David L.
AU - Slovut, David P.
AU - Kamath, Ravi
AU - Jaff, Michael R.
PY - 2012/4
Y1 - 2012/4
N2 - BACKGROUND: While intermittent claudication is the hallmark of symptomatic peripheral artery disease, most patients with peripheral artery disease have atypical symptoms. The presence of lumbosacral spine disease, a common cause of nonvascular lower extremity pain, may confound the diagnosis of peripheral artery disease. The goal of this study was to quantify the prevalence of severe lumbar spine degenerative disease in patients referred for lower extremity arterial studies. METHODS: All patients over age 18 years referred for segmental limb pressures and pulse volume recordings at rest and following treadmill exercise testing at a tertiary medical center accredited vascular diagnostic laboratory, who also underwent magnetic resonance imaging or computed tomography of the lumbar spine within 6 months of the arterial studies, were included in the analysis. Frequencies of peripheral artery disease and lumbar spine degenerative disease were determined, and medical records were reviewed for cardiovascular risk factors and prior vascular and spinal interventions. RESULTS: One hundred seven subjects (63 men) with a mean age of 70 years (range 35-88 years) were included in the analysis. Lumbar spine disease was present in 81 (75.7%) of the patients referred for vascular testing. The percentage of lumbar spine disease was equivalent in both patients with exercise-induced deterioration in arterial pressure and in those with a physiologic response to exercise. Compared with patients with a normal response to exercise, patients with exercise-induced peripheral artery disease had a lower resting ankle-brachial index (mean 0.79 vs 1.09, P <.001), abnormal pulse volume recordings, and were less likely to use opiate analgesics and more likely to have undergone lower extremity revascularization. CONCLUSIONS: Severe lumbar spine degenerative disease is widely prevalent in patients referred for lower extremity arterial studies. Our findings may help explain the high prevalence of atypical limb symptoms among peripheral artery disease patients.
AB - BACKGROUND: While intermittent claudication is the hallmark of symptomatic peripheral artery disease, most patients with peripheral artery disease have atypical symptoms. The presence of lumbosacral spine disease, a common cause of nonvascular lower extremity pain, may confound the diagnosis of peripheral artery disease. The goal of this study was to quantify the prevalence of severe lumbar spine degenerative disease in patients referred for lower extremity arterial studies. METHODS: All patients over age 18 years referred for segmental limb pressures and pulse volume recordings at rest and following treadmill exercise testing at a tertiary medical center accredited vascular diagnostic laboratory, who also underwent magnetic resonance imaging or computed tomography of the lumbar spine within 6 months of the arterial studies, were included in the analysis. Frequencies of peripheral artery disease and lumbar spine degenerative disease were determined, and medical records were reviewed for cardiovascular risk factors and prior vascular and spinal interventions. RESULTS: One hundred seven subjects (63 men) with a mean age of 70 years (range 35-88 years) were included in the analysis. Lumbar spine disease was present in 81 (75.7%) of the patients referred for vascular testing. The percentage of lumbar spine disease was equivalent in both patients with exercise-induced deterioration in arterial pressure and in those with a physiologic response to exercise. Compared with patients with a normal response to exercise, patients with exercise-induced peripheral artery disease had a lower resting ankle-brachial index (mean 0.79 vs 1.09, P <.001), abnormal pulse volume recordings, and were less likely to use opiate analgesics and more likely to have undergone lower extremity revascularization. CONCLUSIONS: Severe lumbar spine degenerative disease is widely prevalent in patients referred for lower extremity arterial studies. Our findings may help explain the high prevalence of atypical limb symptoms among peripheral artery disease patients.
KW - Claudication
KW - Peripheral artery disease
KW - Spinal stenosis
UR - http://www.scopus.com/inward/record.url?scp=84858980135&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858980135&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2011.09.008
DO - 10.1016/j.amjmed.2011.09.008
M3 - Article
C2 - 22444105
AN - SCOPUS:84858980135
SN - 0002-9343
VL - 125
SP - 411
EP - 415
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 4
ER -