Said Abdirahman Ahmed, Osman Farah Dahir, Abdijalil Abdullahi Ali, Abdishakur Abdiqadir Mahdi, Abdillahi Mohamed Abdi, Ahmed Elmi Abdi, Ahmed Shafie Aden, Ishak Ahmed Abdi, Mohamud Mire Waberi, Mohamed Abdullahi Mohamud, Abdullahi Mohamed Hassan Fujeyra, Mohamed Sheikh Hassan, Feyza Aksu, Mahad Sadik Mukhtar, Nurto Abdulkadir Said, Ismail Gedi Ibrahim
In this exploratory cohort, serum endocan concentrations were numerically higher in patients with PAD, but the between-group difference was not statistically significant and no independent association with PAD was demonstrated after adjustment. Interpretation is materially limited by the cardiovascular risk-enriched comparator population, in whom generalized endothelial activation and possible subclinical PAD may have reduced between-group separation. These findings do not validate endocan as a PAD-specific diagnostic biomarker and cannot be extrapolated to comparisons with low-risk healthy populations. Rather, they generate hypotheses for future studies using uniformly phenotyped healthy and risk-matched comparator groups.
Chronic dizziness in elderly patients, particularly when reproducibly triggered by upper limb exertion, should prompt evaluation for arm-exertion-provoked vertebrobasilar hypoperfusion due to subclavian steal syndrome. Duplex ultrasonography can identify complete retrograde vertebral artery flow and confirm complete Grade III subclavian steal physiology, highlighting a treatable vascular cause that may otherwise be misattributed to vestibular, medication-related, or neurodegenerative disease.