FREQUENCY OF MEDIAL CALCINOSIS IN PATIENTS AGED OVER 70 WITH POSTERIOR TIBIAL AND DORSALIS PEDIS ASPHYGMIA

Purpose: Medial calcinosis is a frequent disease in the elderly and in patients with diabetes mellitus and/or advanced chronic renal failure. Many Romanian physicians don't know the clinical features and has the tendency to underestimate the frequency and the importance of the disease. The aim of the study was to evaluate the frequency of medial calcinosis in elders with unilateral or bilateral distal asphygmia of the lower limbs and without diabetes mellitus and chronic renal failure and to initiate a training program for managing this arterial disease.

Methods and Materials: We analysed 200 consecutive patients aged over 70, with tibial and dorsalis pedis asphygmia (their clinical diagnosis was peripheral occlusive arterial disease), admitted in Medical Clinic V Cluj-Napoca during two years (2001–2002). The systolic blood pressure of posterior tibial and dorsalis pedis arteries was measured, bilaterally, by continuous-wave Doppler technique and was reported to the brachial systolic blood pressure to obtain the ankle/brachial pressure index. Medial calcinosis was defined by index values higher than 1.3. Ischemia was defined by values lower than 0.9, at one or two of the distal arteries.

Results: Medial calcinosis was found in 68 patients (34%). 49 patients with mean age 75.3±3.8 years had isolated medial calcinosis (24.5%). 19 patients (mean age 74.6±3.9 years) had medial calcinosis and concomitant distal ischemia (9.5%).

Conclusions: The ankle/brachial pressure index allows to assess medial calcinosis in elders with distal asphygmia. There were no statistical differences of frequency between the ages of these patients. It's very important to initiate a program for understanding that asphygmia doesn't mean only ischemia.