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Asymmetry in prevalence of femoral but not carotid atherosclerosis

Bossuyt, Jellea; Van Bortel, Luc M.a; De Backer, Tine L.M.a; Van De Velde, Sandriena; Azermai, Majdaa; Segers, Patrickb; De Buyzere, Marcc; Van daele, Carolinec; Rietzschel, Ernstc,d

doi: 10.1097/HJH.0000000000000205
ORIGINAL PAPERS: Blood vessels

Objective(s): Atherosclerotic disease is caused by a combination of systemic and local factors (e.g. geometry) affecting local flow conditions. In contrast to the carotid artery, at the iliac-femoral artery region, a large degree of bilateral asymmetry exists. Therefore, we aimed to determine the influence of body side on the prevalence of atherosclerosis (i.e. plaque and intima–media thickness; IMT) at the carotid and femoral arteries.

Methods: Data were used from the ASKLEPIOS study, including 2524 apparently healthy individuals with a mean age of 46 years (range 35–55 years). Echographic images were obtained bilaterally of the carotid and femoral arteries. A single observer approach was used for the acquisition and quantification of plaques and IMT.

Results: The carotid artery displays no significant left-right difference in IMT values nor plaque prevalence (right: 12.0 vs. left 13.3%; P = 0.18). In contrast, for the femoral artery, the IMT distribution at the right common femoral artery is more skewed (P90 right: 1.11 mm, left 1.01 mm; P < 0.001), which is mirrored by a significantly higher plaque prevalence (right: 21.9 vs. left: 15.7%; P < 0.001).

Conclusion: In the present study, atherosclerotic lesions are more prevalent at the right than at the left femoral artery. This finding highlights the possible role of local arterial geometry in the development of atherosclerosis and underscores the importance of the choice of body side when assessing vascular health.

aHeymans Institute of Pharmacology, Clinical Pharmacology

bInstitute Biomedical Technology (IBiTech), Ghent University

cDepartment of Internal Medicine (Cardiovascular Diseases), Ghent University and Ghent University Hospital

dDepartment of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

Correspondence to Jelle Bossuyt, Heymans Institute of Pharmacology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. Tel: +32 9 332 00 42; fax: +32 9 332 88 00; e-mail:

Abbreviations: ATP III, Adult Treatment Panel III; CI, confidence interval; CVD, cardiovascular disease; IFG, Impaired fasting glycemia; IMT, Intima–media thickness; OR, odds ratio; SD, standard deviation; TOD, target organ damage

Received 5 October, 2013

Revised 11 March, 2014

Accepted 11 March, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins