Atherosclerosis of the Femoral ArteriesAtherosclerosis of the Femoral Arteries

Cunnane E.M.

Centre for Applied Biomedical Engineering Research (CABER),Department of Mechanical, Aeronautical and Biomedical Engineering,

and Materials and Surface Science Institute (MSSI).University of Limerick, Ireland.

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• Atherosclerosis– It is a chronic inflammatory response – Arises due to lipid accumulation in intima

• Advancement of Disease: – Cellular waste and calcium mineral deposits– Leads to heavily calcified lesions

Introduction

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– Carotid = Cerebrovascular

– Coronary = Cardiovascular

– Femoral = Peripheral arterial disease

Affected Arteries

Dealing with Diseased Femoral Arteries

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Characterised by:

– Claudication

– Ischemic Ulceration

– Major amputation in 1/3 of critical patients

Peripheral Arterial Disease

1 year mortality rate of 20%

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Bypass Surgery:

– Surgical bypass is the gold standard for femoral artery revascularisation

– It has a 5 year patency rate of nearly 80%

– However, it is highly invasive

Treatment

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Angioplasty and Stenting:

– Deploys balloon to compress plaque and stent to stabilise the artery.

– Advantages:• Lower reintervention rates

• Higher 1 year primary patency

– However, numerous Problems Remain…

Treatment Alternative

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– 85% of procedures develop restenosis

– 65% of procedures develop reocclusion

– Re-intervention is required within 2 years in up to 54% of patients

– The per patient costs are greater than cardiovascular and cerebrovascular disease!!!

Issues in Angioplasty and Stenting

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– Heavily calcified lesions have been shown to destabilises percutaneous intervention.

– This is due to the increase risk of:

• Uncontrolled plaque rupture• Sub-acute stent thrombosis• In-stent restenosis• Arterial dissection

Possible Causes of Issues

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Assess the influence of calcification on plaque failure stability

Achieve this through the mechanical testing of human femoral plaque samples

Research Proposal