engleski

The diagnosis of peripheral arterial disease in hiv-infected patients

Peripheral artery disease (PAD) is a well-known and explored condition in symptomatic and asymptomatic HIV infected patients. Two types of PAD in patients with HIV infected patients can be detected by the use of duplex Doppler: medial arterial calcification (MAC) and peripheral artery occlusive disease. MAC, known also as Mönkeberg disease is a feature of PAD, where calcifications are independent of atherosclerosis. Arterial intimal layer is not involved and the lumen is not reduced as a direct consequence of this disease, but they increase the wall stiffness. Recent pathobiological studies confirmed that MAC is not only a degenerative and passive but an active and dynamic process witch increases arterial stiffness and share many features with embryonic bone formation. B-mode ultrasound is a validated method in examination of medial and intimal arterial calcification and is more sensitive than radiography. Intimal calcification is usually focal with irregular surface. In ultrasonic studies MAC is described as smooth, linear calcification without lumen stenosis. Duplex imaging of peripheral arteries is a non-invasive imaging method and is the most common test modality for detection of PAD. Duplex imaging provides: B-mode to visualize the vascular anatomy and morphology combined with Doppler modality to analyse flow information for a selected region. In this review we will explain a value and advantages of vascular ultrasound in the detection of PAD in HIV infected patients in carotid arteries, abdominal aorta and lower limb arteries.

peripheral artery disease ; HIV-infection ; chronic renal disease

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