TORTUOSITY AND ATHEROSCLEROSIS IN THE FEMORAL-ARTERY - WHAT IS CAUSE AND WHAT IS EFFECT

Earlier studies have demonstrated a correlation between tortuosity and atherosclerosis in the femoral artery. One conceivable explanation is that atherosclerosis causes an elongation of the artery, resulting in vessel tortuosity; another is that blood flow phenomena (such as flow separation) due to the vessel geometry may affect the progression of atherosclerosis. To determine which of these hypotheses is most likely , a group of 232 hyperlipidemic patients was followed with angiography for 3 years during lipid-lowering treatment. After digitization of th e films, a tortuosity value and an atherosclerosis measure (edge rough ness) were computed. In the group with lower tortuosity values, there was a significant (p < 0.0001) decrease in edge roughness, but not in the group with a higher tortuosity values. On the other hand, neither the group with higher edge roughness values nor that with lower edge r oughness values displayed a significant change in tortuosity. When tor tuosity, roughness, and treatment were studied simultaneously, only th e effect of tortuosity on roughness change was significant. These find ings are more consistent with tortuosity influencing the development o f atherosclerosis than with its being a consequence of atherosclerosis .