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3 . 2026

Biomechanics in occlusive lesions of the femoropopliteal arterial segment (literature review)

Abstract

Background. Peripheral artery disease remains one of the leading causes of limb amputation, thus resulting in disability and decreased quality of life. Despite the development of open and interventional technologies, therapeutic outcomes are far from ideal. The greatest difficulties arise in treatment of patients with femoropopliteal arterial lesions, not least because this is the most active segment from the point of view of biomechanics. Therefore, studying biomechanical factors in this anatomical segment seems currently important.

Objective. To systematize the modern data on the role of biomechanical forces in the pathogenesis of occlusive diseases of arteries of the femoropopliteal segment and substantiate the need to take into account biomechanical parameters in therapeutic decision-making.

Material and methods. We analyzed Russian and foreign studies dedicated to biomechanics of the femoropopliteal segment, shear stress, methods of angioplasty and stenting, as well as mathematical modeling, using the data of meta-analyses and randomized studies.

Results. According to the National Health and Nutrition Examination Survey (NHANES), the prevalence of a decreased ankle-brachial index below 0.9 is 4.64% in the general population, amounting to 16.62% in people older than 72 years. While walking, the distal portions of the femoral and popliteal arteries experience axial shortening to 13.9%, twisting to 3.5°/cm, and compression to 12.5%. The shear stress in the femoral artery amounts to 0.3–0.5 Pa, with its oscillating pattern being a powerful pro-atherogenic signal.

Conclusion. Biomechanical forces largely determine the localization of atherosclerotic lesions and risk of restenosis after surgery. Personalized mathematical modeling with due regard for individual anatomy and mechanical properties of arteries is a promising direction of predicting therapeutic outcomes and optimizing the tactics of revascularization for lesions of the femoropopliteal segment.

Keywords:peripheral artery disease; biomechanics; femoropopliteal segment; shear stress; atherosclerosis; stenting; personalized modeling

Authors’ contribution. Study conception and design – Komarova L.N., Martynov V.G.; data collection and handling, analysis of literature sources – Mashukova M.S., Mashukov A.Yu.; draft manuscript preparation – Mashukova M.S.; manuscript revision – Komarova L.N., Martynov V.G.

For citation: Komarova L.N., Martynov V.G., Mashukova M.S., Mashukov A.Yu. Biomechanics in occlusive lesions of the femoropopliteal arterial segment (literature review). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2026; 32 (3): 27–33. DOI: https://doi.org/10.33029/1027-6661-2026-32-3-27-33

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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