The Impact of Endovascular Lower-limb Revascularisation on the Aortic Augmentation Index in Patients with Peripheral Arterial Disease

Objectives: The aortic augmentation index (Alx), a marker of arterial stiffness, and peripheral arterial disease (PAD) are associated with an increased cardiovascular risk. In claudicants, the effect of balloon angioplasty (percutaneous transluminal angioplasty, PTA) on Alx has not been determined so far. Methods: Measurements of the ankle-brachial pressure index (ABI) and Alx were performed before and 3 months after PTA and compared to age- and sex-matched PAD patients under best medical treatment. Results: The data of 61 patients (44% female, mean age 68 years) who underwent lower-limb PTA was compared to 48 conservatively treated patients (38% female, mean age 68 years). ABI significantly improved after PTA from 0.73 +/- 0.02 to 0.85 +/- 0.03 (p = 0.001), but remained unchanged in the control group (0.85 +/- 0.23 and. 0.80 +/- 0.21; p = 0.16). Revascularisation was associated with a significant reduction of Alx from 31.5 +/- 1.1% to 28.8 +/- 1.1% after 3 months (p = 0.01). In the conservatively treated group, Alx did not change during follow-up (29.9 +/- 1.1% to 29.9 +/- 1.1%; p = 0.83). Conclusion: Lower-limb revascularisation in PAD Rutherford stage II-III is associated with an improvement of markers for arterial stiffness. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.