The development of peripheral artery disease (PAD) is a complex process that leads to functional impairment and amputation. The presence of medial artery calcification (MAC) predicts amputation and poor outcomes and is a major impediment to surgical remission of occlusive disease. Lithotripsy is used to break up calcification however how this treatment contributes to the high incidence of subsequent restenosis is unclear. Here we will combine the clinical expertise of Patel in vascular surgery and precision medicine with novel PET imaging science of T. M. de Rosales with the basic science expertise of Shanahan to understand the pathogenesis of vascular occlusion in PAD and develop new imaging-based methods to identify and risk stratify patients with restenosis.
