Date of Award

Spring 2022

Degree Type



Biological Sciences

Director of Thesis

Susan Lessner, Ph.D.

First Reader

Mohamad Azhar, Ph.D.

Second Reader

Mohamad Azhar, Ph.D.


Amputation due to complications related to vascular diseases such as peripheral arterial disease (PAD) is rising across the nation, especially in South Carolina. PAD can not only lead to severe outcomes such as gangrene and death but sometimes also leave patients with the sole option of amputation, which can decrease quality of life and increase the financial burden on the patient. In light of the growing amputation trend and the increasing prevalence of PAD, this research project aimed to assess the utility of calcification scores and plasma protein biomarkers such as thrombospondin-1 and osteoactivin as potential indicators of PAD progression. To do this, patients with chronic limb threatening ischemia or recalcitrant intermittent claudication who underwent a femoral endarterectomy (FEA) were admitted to this study. The arterial plaque samples obtained from the FEA were analyzed for calcification using micro-CT scans, while the patients’ clinical CTA scans were also analyzed for calcification. The patients’ plasma samples were analyzed with sandwich ELISA assays to detect the expression of the plasma protein biomarkers. Calcification scores obtained from the CTA scans were significantly and positively correlated to calcification scores obtained from micro-CT scans, indicating that calcification in individual plaque samples is representative of global calcification in the lower peripheral arteries. Furthermore, although osteoactivin concentrations did not show any significant difference in FEA patients compared to controls, thrombospondin-1 was significantly upregulated in FEA patients. It was thus concluded that thrombospondin-1 could serve as a potential indicator of PAD progression.

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© 2022, Shuvangee Dhar

Available for download on Monday, April 29, 2024