Plaque distribution in common femoral artery bifurcations, based on multi-slice computed tomography assessment

Bihui Zhang, Min Yang, Yinghua Zou


Purpose: The aim of this study was to observe the exact plaque distribution at the common femoral artery bifurcation by multi-slice computed tomography angiography and to examine the relationship between plaque distribution and carina location.

Methods: Symptomatic outpatients who underwent multi-slice computed tomography angiography between May 2013 and February 2015 were enrolled in this study. The presence and distribution of atherosclerotic plaques were assessed in cross section views of vessel lumen. Each vessel lumen cross section was divided into four equal quadrants for the common femoral, superficial femoral and profunda femoral arteries. The quadrant of the superficial femoral artery in which the carina was located was also recorded.

Results: In total, 184 common femoral artery bifurcations in 92 patients were analyzed. Normal arteries were more common in profunda femoral arteries than in common femoral arteries and superficial femoral arteries (both P< 0.001). Plaques were found more medial and posterior quadrants in common femoral arteries. In superficial femoral arteries, plaques were found most frequently in anterior quadrants (78.3%, n=144) and least frequently in posterior quadrants (49.5%, n=91). The carina was located in the posterior quadrant in 160 bifurcations (87.0%) of superficial femoral arteries. Quadrants opposite the carina contained plaque most proportionally (77.2%) and quadrants of carina were affected least proportionally (52.7%) in superficial femoral arteries (P <0.001). Quadrants adjacent to the carina clockwise or anticlockwise also contained a higher proportion than carina quadrants. Significance was found for anticlockwise quadrants (p=0.002), but not for clockwise quadrants (P=0.21).

Conclusions: The presence and distribution of atherosclerotic plaques were diverse in different artery beds of the common femoral artery bifurcations. Plaque tended to be located in areas opposite the carina in superficial femoral arteries.

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