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Journal articles on the topic 'Peripheral arterial obliterative disease'

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Published: 9 March 2023

Last updated: 10 March 2023

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1

Montron, Armelle, Eric Guignard, Alain Pelc, and Sylvie Comte. "Peripheral Arterial Obliterative Disease." PharmacoEconomics 13, no. 1 (1998): 51–59. http://dx.doi.org/10.2165/00019053-199813010-00005.

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2

Landi, Anna, and István Jassó. "Peripheral arterial obliterative disease and physical activity." Orvosi Hetilap 148, no. 23 (June 1, 2007): 1059–65. http://dx.doi.org/10.1556/oh.2007.28141.

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Az arteriosclerosis obliterans az atherothrombosis egyik karakterisztikus klinikai manifesztációja. Előfordulása 2–3%, tehát Magyarországon 2–300000 beteggel kell számolni. Gyakori az együttes előfordulása a coronariasclerosissal és a carotisrendszer atherothromboticus megbetegedésével. A perifériás obliterativ verőér-megbetegedés terápiájában a rendszeres fizikai tréning alapvetően fontos. Az arteriosclerosis obliterans kezelése a társult atheroscleroticus betegségek előfordulását, illetve kimenetelét is befolyásolja. A rendszeres fizikai tréning fő célja a perifériás érbetegek életminőségének javítása, az alsó végtagok funkcionális kapacitásának növelése. A reguláris, egyénre szabott járatás, tornagyakorlatok több olyan folyamatot indítanak el a szervezetben, melyek az atherosclerosis kialakulását, tovahaladását gátolják. Tréning alatt számolni kell a stenoticus érszakasz nyomásgrádiens-növekedéséből és a kollaterálisok megnyílásából álló hemodinamikai változásokkal, az endothel diszfunkció javulásával, a terhelésre jó irányba módosuló vascularis válasszal. A kórképet jellemző diszlipidémiát kedvezően befolyásolja; az LDL-koleszterint csökkenti, a HDL-t növeli. Jótékonyan befolyásolja a vér reológiai tulajdonságait is. A vázizomzatban strukturális változásokat hoz létre, az anyagcsere oxidációs folyamatainak enzimkoncentrációját növeli, és fokozza a célzott vázizomzat rostjainak kapilláris ellátottságát. Az eddig publikált adatok szerint a claudicatio intermittens kezelésében legelőnyösebben legalább heti 3 alkalommal végzett, 30–60 percen át tartó, 5–5 perces bemelegítést és levezetést is tartalmazó, szakember által irányított 3–6 hónapos, járásgyakorlatok formájában kivitelezett tréningkurzus ajánlatos. Az otthon végzett gyakorlatok hasznossága is figyelemre méltó.

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3

ROSSI, M., and A. CARPI. "Skin microcirculation in peripheral arterial obliterative disease." Biomedecine & Pharmacotherapy 58, no. 8 (October 2004): 427–31. http://dx.doi.org/10.1016/s0753-3322(04)00114-3.

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4

Rossi, M., and A. Carpi. "Skin microcirculation in peripheral arterial obliterative disease." Biomedicine & Pharmacotherapy 58, no. 8 (October 2004): 427–31. http://dx.doi.org/10.1016/j.biopha.2004.08.004.

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5

Coccheri, S., G. Palareti, and G. Fortunato. "Antithrombotic Drugs in Peripheral Obliterative Arterial Diseases." Pathophysiology of Haemostasis and Thrombosis 24, no. 2 (1994): 118–27. http://dx.doi.org/10.1159/000217091.

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6

Materazzi, M., L. Ralli, A. Bianciardi, L. Domini, A. Monaci, D. Pieragalli, A. Acciavatti, C. Galigani, S. Forconi, and T. DiPerri. "Arterial-venous differences in metabolic and rheological parameters in peripheral obliterative arterial disease patients." Clinical Hemorheology and Microcirculation 7, no. 2 (December 9, 2016): 253–60. http://dx.doi.org/10.3233/ch-1987-7209.

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7

Darius, H., V. Hossmann, and K. Schrör. "Antiplatelet effects of intravenous iloprost in patients with peripheral arterial obliterative disease." Klinische Wochenschrift 64, no. 12 (June 1986): 545–51. http://dx.doi.org/10.1007/bf01735317.

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8

Despotovic, Nebojsa, and Mihajlo Zdravkovic. "Multiple arterial disease in clinical practice." Srpski arhiv za celokupno lekarstvo 130, no. 9-10 (2002): 316–19. http://dx.doi.org/10.2298/sarh0210316d.

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There is a significant correlation among obliterate lesions of coronary carotid and peripheral arteries of the lower arteries at the same time. This pointed out that whenever clinical manifestations of obliterate disease of peripheral arteries are present. There is also need for routine examination of existent coronary artery disease. In the case of concomitant significant coronary and carotid vascular disease there is a question what should be operated first. The most vascular centres prefer carotid endarterectomy before aortocoronary bypass, and if there is nonstable coronary disease simultaneous carotid endarterectomy and aortocoronary bypass should be carried out.

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9

Skórkowska-Telichowska, Katarzyna, Rajmund Adamiec, Dominika Tuchendler, and Kazimierz Gąsiorowski. "Susceptibility to apoptosis of lymphocytes from patients with peripheral arterial disease." Clinical & Investigative Medicine 32, no. 5 (October 1, 2009): 345. http://dx.doi.org/10.25011/cim.v32i5.6922.

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Purpose. To determine, in vitro, the susceptibility to apoptosis of lymphocytes from patients with peripheral arterial disease (PAD) in the presence of a low culture medium serum concentration, and to evaluate the correlation of the degree of apoptosis and the serum lipid levels. Methods. Lymphocytes were isolated from the venous blood of PAD patients with lower limb ischemia secondary to obliterative atherosclerosis of Fountain stage IIb. None of the patients had received hypo-lipemic therapy. The lymphocytes were incubated for 48 hr in media containing reduced concentrations of fetal calf serum. The study group consisted of 10 patients (7 men and 3 women), with a mean age of 67.0 ± 4.0 yr. The control group consisted of ten healthy volunteers, of the same mean age and sex proportion as the study group. Results. The percentage of non-apoptotic lymphocytes was lower (by 17%) and the percentage of late apoptotic lymphocytes was higher (by 33%) in the PAD patients than in the healthy donors when comparing the slopes of regression lines describing the relation between frequency of apoptotic lymphocytes in culture media containing reduced concentration of fetal calf serum The percentage of late apoptotic lymphocytes was correlated with the levels of total cholesterol (rs=0.93; P < 0.01) and LDL cholesterol (rs=0.80; P < 0.01) , and negatively correlated with the level of triglycerides (rs=-0.71; P < 0.05). Conclusion. The results of this study of lymphocyte apoptosis are important in understanding of the disease pathogenesis and should be taken into account in elaboration of treatment strategies.

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10

Rosato, Maria Laura, Luca Schiaffino, Margherita Luongo, Luigi Mascolo, Silvana Mattera, and Marco Mainini. "Oxygen-ozone therapy effects on PaO2 value in a diabetic patient suffering from chronic peripheral obliterative arteriopathy." Ozone Therapy 1, no. 1 (April 5, 2016): 21. http://dx.doi.org/10.4081/ozone.2016.5843.

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We define chronic occlusive arterial disease of the extremities (COAD) as the aging process of the arterial vessel wall, characterized by the formation of atherosclerotic plaques. Patients suffering from COAD often refer induced pain exercise. Previous studies described benefic effects of oxygen-ozone (O<sub>2</sub>-O<sub>3</sub>) therapy in treatment of COAD. We describe a case of a 69-year old man, suffering from COAD, treated with O<sub>2</sub>-O<sub>3</sub> therapy. The aim of our report was to evaluate not only the effects of the oxygen-ozone therapy on the patient, but also the influence of this method on the arterial partial pressure of oxygen value.

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11

Bielawiec, M., K. Krupiński, A. Szpak, A. Plonowski, and A. Bodzenta-Lukaszyk. "Blood cell function and vascular effect of indobufen in patients with peripheral obliterative arterial disease (POAD)." Thrombosis Research 65 (January 1992): S147. http://dx.doi.org/10.1016/0049-3848(92)90606-b.

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12

Jassó, István, Anna Landi, and Elek Dinya. "Risk status of patients with peripheral arterial disease (PAD)." Orvosi Hetilap 148, no. 52 (December 1, 2007): 2469–76. http://dx.doi.org/10.1556/oh.2007.28257.

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A szerzők 168 perifériás obliteratív verőérbeteg és 82 kontrollszemély hagyományos és újabb klinikai és laboratóriumi rizikófaktorait vizsgálták. A betegek között 30,4%-ban fordult elő cukorbetegség, 39,9%-ban ischaemiás szívbetegség, 6,5%-ban cerebrovascularis betegség; ischaemiás szívbetegség, cerebrobvascularis betegség és perifériás obliteratív verőérbetegség együtt 7,1%-ban volt jelen. A hipertónia és az aktív dohányzás előfordulása az érbetegek és a kontrollok között rendre 76,2 és 46,3%, illetve 49,4 és 28% volt. A laboratóriumi paraméterek közül a HDL-koleszterin és az ApoA1 átlagértéke számottevően alacsonyabb, míg a triglicerid, a plazmaviszkozitás, a fehérvérsejtszám, a fibrinogén-, a hsCRP-, a homocystein-, a kreatinin- és a húgysavszint szignifikánsan magasabb volt a betegcsoportban. Az érbetegcsoporton belül a dohányos és diabéteszes betegek laboratóriumi értékeiben további kedvezőtlen jelentős eltérések voltak észlelhetők a nem dohányzó, illetve a nem diabéteszes betegekéhez képest. Korreláció volt a betegeknél a hsCRP- és rendre a fehérvérsejtszám, a plazmaviszkozitás és a fibrinogénkoncentráció között. Az általunk kiválasztott 16 rizikófaktor vizsgálatakor a betegek átlagos rizikófaktorszáma magas, 7,79 volt. A betegek közül 118 részesült antilipidaemiás kezelésben, thrombocytaaggregáció-gátlót 142 fő kapott. Eredményeink alapján hangsúlyozható, hogy a perifériás obliteratív verőérbetegek magas rizikófaktorszámuk miatt kiemelt veszélyeztetettségűek, következésképpen a szekunder prevenciónak a kockázati tényezők minél teljesebb befolyásolását kell céloznia.

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13

Narula, Nupoor, Jeffrey W. Olin, and Navneet Narula. "Pathologic Disparities Between Peripheral Artery Disease and Coronary Artery Disease." Arteriosclerosis, Thrombosis, and Vascular Biology 40, no. 9 (September 2020): 1982–89. http://dx.doi.org/10.1161/atvbaha.119.312864.

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Atherosclerosis is a systemic disease that involves multiple vascular beds. The pathological characteristics and clinical presentation, however, vary among the different vascular territories. Acute coronary syndrome is a relatively common manifestation of coronary atherosclerotic disease, wherein the thrombosis occurs secondary to disruption (65%–75%) and erosion (25%–35%) of the fibrous caps of atheromatous plaques. The plaques associated with plaque rupture have large necrotic cores and thin and inflamed fibrous caps. However, the pathological manifestations of peripheral artery disease result from thrombosis regardless of the extent of atherosclerosis. Approximately 75% of peripheral arteries with significant stenosis demonstrate presence of thrombi, of which two-thirds have thrombi associated with insignificant atherosclerosis. The presence of obliterative thrombi in peripheral arteries of patients with critical limb ischemia in the absence of coronary artery–like lesions suggests a locally thrombogenic or remotely embolic basis of disease. Extensive calcification of the medial vascular layer is commonly observed. In this review, we have described and compared the pathological basis of coronary and peripheral artery disease in patients with acute coronary syndrome and critical limb ischemia. It is expected that pathogenetic characterization would allow for definition of strategic targets for superior management of peripheral artery disease.

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14

Fagrell, Bengt. "How best to evaluate skin viability and the effect of therapy in patients with peripheral obliterative arterial disease." Vascular Medicine Review vmr-1, no. 1 (March 1990): 59–68. http://dx.doi.org/10.1177/1358836x9000100106.

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15

Katorkin, S. E., E. P. Krivoshchekov, E. B. Elshin, and M. Y. Kushnarchuk. "Modern possibilities and prospects of conservative treatment of patients with peripheral arterial diseases." Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) 19, no. 2 (November 19, 2022): 50–60. http://dx.doi.org/10.21518/1995-1477-2022-19-2-50-60.

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The most common clinical manifestation of peripheral arterial disease is intermittent claudication due to insufficient blood supply to the affected limb. The article summarizes and systematizes the latest achievements in the field of conservative treatment of patients with intermittent claudication. In accordance with the requirements of evidence-based medicine, an overview of modern promising trends in conservative therapy presented in the latest Russian and foreign consensus documents, is given. The basis of the complex treatment of patients with peripheral arterial diseases is: non-drug and drug treatment to relieve the symptoms of chronic ischemia, pharmacotherapy for the secondary prevention of cardiovascular complications, open or endovascular revascularization to increase the distance of painfree walking. With the development of atherosclerosis, disturbances in the peptide composition of the endothelium occur, which reduce the ability of the vascular wall to resist inflammation and the associated triggering of pathological processes. It has been experimentally proven that the use of a complex of peptides obtained from the vessels of healthy and young animals in this situation restores the endothelial function of the arteries, affecting the main links of pathogenesis. Decrease in oxidative stress, decrease in atherogenic and lipidemic action, normalization of vascular tone and blood coagulation parameters, increase in the microvascular bed – these are the mechanisms that justify the indication of peptides to patients with atherosclerosis obliterans. Angioprotector based on a complex of polypeptides isolated from blood vessels can become an important part of the treatment of patients with obliterating diseases of the arteries of the lower extremities, providing a complex pathogenetic effect. It is necessary to further study in multicenter clinical trials the duration of the therapeutic effect of a drug in a longer period after a course of treatment, its effect on long-term outcomes of the disease, the possibility of using repeated courses, in chronic obliterating diseases of the arteries of the lower extremities III-IV stages according to the Fontaine classification, as well as the use drug for the treatment of systemic atherosclerosis of various arterial basins.

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16

Vukobratov, Vladimir, Janko Pasternak, Jovan Obradovic, Milos Kacanski, Vladan Popovic, and Dragan Nikolic. "Results of autovenous femoro-distal bypass procedures in the type III peripheral obliterative arterial disease of the extremities in diabetic and nondiabetic patients." Medical review 59, no. 9-10 (2006): 472–75. http://dx.doi.org/10.2298/mpns0610472v.

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Introduction. It has been established that infrainguinal occlusive disease, type III peripheral obliterative arterial disease (POAD), is more common in diabetics than in non-diabetics. It is presumeable that after surgical treatment of this arterial segment diabetics develop more complications and higher mortality rate than nondiabetics. The aim of this study was to analyze the results of reconstructive surgical treatment of diabetic and non-diabetic patients with type III PAOD. Material and Methods. In the period 1999-2003, 118 patients with Type III PAOD underwent surgery at the Vascular Surgery Clinic in Novi Sad. They were divided into two groups: group I included 51 nondiabetic patients, and group II 67 diabetic patients. Subgroups were formed based on the clinical status. Differences were established in IVa, (46 diabetics and 4 non-diabetics) and IVb stage (11 diabetic and 30 non-diabetic patients). Results. Statistical data analysis using X2 test showed a statistical difference in complications rates, number of salvaged limbs and finally, in the mortality rates between diabetic and non-diabetic patients. Conclusion. Diabetic patients presented with significantly more trophic skin lesions (IVa stage). The overall complication rate was significantly higher in diabetics, as well as the amputation rate. Finally, the mortality rate was also significantly higher in diabetics than in nondiabetic patients. .

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17

Glushkov, Nikolay I., Michael A. Ivanov, Petr D. Puzdryak, Kristina V. Samko, Alina A. Isakova, and Anastasia S. Artemova. "Metabolic disorder and outcomes of reconstructive interventions in patients with peripheral arterial disease." HERALD of North-Western State Medical University named after I.I. Mechnikov 11, no. 3 (November 18, 2019): 33–40. http://dx.doi.org/10.17816/mechnikov201911333-40.

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The purpose of this study was to assess the effect of metabolic disorders on the effects of revascularization in patients with obliterating atherosclerosis. Materials and methods. The reconstruction was performed in 253 patients with femoral-tibial arterial segment lesion (98 open operations, 116 endovascular interventions and 39 patients were treated with hybrid technique). Results. Endovascular revascularization techniques are justified in case of disorders of carbohydrate metabolism. Conventional operations remain the method of choice in the case of those variants of atherosclerotic lesions, where minimally invasive techniques are impossible. Conclusions. Metabolic disorders in patients with peripheral atherosclerosis on the background of severe comorbid pathology may be the basis for choosing hybrid methods of revascularization.

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18

Yaku, Ai, Tadakatsu Inagaki, Ryotaro Asano, Makoto Okazawa, Hiroyoshi Mori, Ayuko Sato, Fabian Hia, et al. "Regnase-1 Prevents Pulmonary Arterial Hypertension Through mRNA Degradation of Interleukin-6 and Platelet-Derived Growth Factor in Alveolar Macrophages." Circulation 146, no. 13 (September 27, 2022): 1006–22. http://dx.doi.org/10.1161/circulationaha.122.059435.

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Background: Pulmonary arterial hypertension (PAH) is a type of pulmonary hypertension (PH) characterized by obliterative pulmonary vascular remodeling, resulting in right-sided heart failure. Although the pathogenesis of PAH is not fully understood, inflammatory responses and cytokines have been shown to be associated with PAH, in particular, with connective tissue disease-PAH. In this sense, Regnase-1, an RNase that regulates mRNAs encoding genes related to immune reactions, was investigated in relation to the pathogenesis of PH. Methods: We first examined the expression levels of ZC3H12A (encoding Regnase-1) in peripheral blood mononuclear cells from patients with PH classified under various types of PH, searching for an association between the ZC3H12A expression and clinical features. We then generated mice lacking Regnase-1 in myeloid cells, including alveolar macrophages, and examined right ventricular systolic pressures and histological changes in the lung. We further performed a comprehensive analysis of the transcriptome of alveolar macrophages and pulmonary arteries to identify genes regulated by Regnase-1 in alveolar macrophages. Results: ZC3H12A expression in peripheral blood mononuclear cells was inversely correlated with the prognosis and severity of disease in patients with PH, in particular, in connective tissue disease-PAH. The critical role of Regnase-1 in controlling PAH was also reinforced by the analysis of mice lacking Regnase-1 in alveolar macrophages. These mice spontaneously developed severe PAH, characterized by the elevated right ventricular systolic pressures and irreversible pulmonary vascular remodeling, which recapitulated the pathology of patients with PAH. Transcriptomic analysis of alveolar macrophages and pulmonary arteries of these PAH mice revealed that Il6, Il1b , and Pdgfa/b are potential targets of Regnase-1 in alveolar macrophages in the regulation of PAH. The inhibition of IL-6 (interleukin-6) by an anti–IL-6 receptor antibody or platelet-derived growth factor by imatinib but not IL-1β (interleukin-1β) by anakinra, ameliorated the pathogenesis of PAH. Conclusions: Regnase-1 maintains lung innate immune homeostasis through the control of IL-6 and platelet-derived growth factor in alveolar macrophages, thereby suppressing the development of PAH in mice. Furthermore, the decreased expression of Regnase-1 in various types of PH implies its involvement in PH pathogenesis and may serve as a disease biomarker, and a therapeutic target for PH as well.

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19

Mshar, S. V., and V. Yanushko. "THE ROLE OF X-RAY ENDOVASCULAR SURGERY IN THE TREATMENT OF OBLITERATING ATHEROSCLEROSIS OF THE LOWER EXTREMITY ARTERIES IN ELDERLY AND SENILE PATIENTS." Emergency Cardiology and Cardiovascular Risks 4, no. 2 (2020): 1069–73. http://dx.doi.org/10.51922/2616-633x.2020.4.2.1069.

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Obliterating atherosclerosis ranks third in the system of cardiovascular disease. With age the incidence of peripheral artery disease increases and makes 3-5% in general population. The most difficult group of patients with peripheral artery disease (PAD) or obliterating atherosclerosis is elderly patients. Currently there is a tendency to increase the life expectancy and aging of the Belarusian population. Elderly and senile patients with obliterating atherosclerosis (PAD) are characterized by a multi-level lesion and damage to the distal parts of the arterial bed, an increase in the number of comorbidities, a high risk of cardiovascular death, and seeking medical help often at the stage of critical lower limb ischemia. Patients at high risk of cardiovascular complications with intermittent lameness are subject to conservative treatment. When developing a clinic for critical lower limb ischemia, due to the low effectiveness of conservative methods of treatment, it is worth considering revascularization of the lower limb arteries. Open surgical methods of treatment are associated with a high risk of complications and mortality. X-ray endovascular methods of treatment of patients of the older age group are characterized by a lower risk of complications, lower injury rate. The use of low-injury x-ray endovascular and hybrid methods of treatment in elderly and senile patients can improve the results of treatment (reduce the frequency of amputations, reduce the risk of complications, improve the quality of life).

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20

Maslov, A. L., and A. E. Zotikov. "A Score of Run-Off (Outflow) Resistance in Lesions Femoropopliteal Arteries Using MSCT Angiography." Medical Visualization, no. 2 (April 28, 2017): 90–102. http://dx.doi.org/10.24835/1607-0763-2017-2-90-102.

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Despite the ongoing treatment, in 10–20% of patients with obliterating diseases of the arteries of the lower limbs, the progression of the disease leads to amputation, with mortality rates being up to 50%.The aim: to determine the effectiveness of MSCT angiography in patients with type-D femoral-popliteal arteries according to TASC II with critical ischemia of the lower extremities and poor condition of outflow tracts for performing arterialization of venous blood flow and / or superimposition of arteriovenous fistula.Material and methods. 145 MSCT angiographic studies were performed for patients with arterial diseases of the lower extremities performed in “RAMSAY Diagnostics Rus”Moscow. For the analysis, 53 (37% of the total) of the patient with lesions of the femoropopliteal segment of Type D according to TASC II were selected. The analysis of the state of the arterial outflow pathways was carried out according to the modified Rutherford classification, where each artery of the shin was maximally assigned 3 points depending on the degree of stenosis, the blood flow resistance was estimated as 0 points – the absence of stenosis or stenosis less than 20%, 1 point stenosis 20–49% 2 points stenosis 50–99%, 3 points – occlusion.Results. The degree of resistance of arteries of outflow tracts of 39 limbs (16 right and 23 left) was calculated in 53 patients: 10 points in 23.7% of cases; 9 points in 5.1%; 8 points – 2.5%; 7 points 18%, 6 points in 5%; 5 points 2.5%; 4 points 15.4%; 3 points 7.7%; 2 points 0; 1 point 20.5%. In patients with poor arterial outflow, with a score greater than 7, there is a high risk of early thrombosis of the prosthesis, so such patients undergo an operation with the formation of an unloading arteriovenous fistula.Conclusion. MSCT angiography of the arteries of the lower extremities is an effective method for determining the severity of arterial damage with an accurate definition of the level, extent, prevalence with the possibility of using different classifications, including TASC II and theRutherford classification. It can be used as a screening, expert method in patients with arterial diseases of the lower extremities, may be an alternative to direct angiography, used to assess patients in the postoperative period.Key words: peripheral arterial disease, outflow score, ball classification of outflow tracts, runoff score, computed tomography, angiography.

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21

Shilkina, N. P., I. V. Dryazhenkova, and I. E. Yunonin. "Modern aspects of the problem of obliterating thrombangiitis." Clinical Medicine (Russian Journal) 100, no. 4-5 (July 21, 2022): 200–208. http://dx.doi.org/10.30629/0023-2149-2022-100-4-5-200-208.

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To present some pathogenesis, diagnostics and treatment of thromboangiitis obliterans (TAO) discussion items in accordance with the contemporary views on the nomenclature, classification, pathogenesis and treatment of rheumatic diseases. Materials and methods. 115 patients with thromboangiitis obliterans under observation in Interregional Consultative Center for the patients with systemic rheumatic diseases were examined. The complex analysis of peripheral circulation was carried out by ultrasonic scintiangiography. The methods of study included: morphological analysis of biopsy, autopsic and operating material by histochemical methods; immunofluorescent method was used for detecting the immune complexes. In 224 patients with systemic vasculitides (SV) serological markers, including the wide spectrum of autoantibodies, C-reactive protein, complement, von Willebrand factor antigen as a marker of defeat of vascular wall were detected. Results. Most diagnostically significant criteria were: age younger than 45 years, male sex, smoking, distal vascular lesions of the extremities and confirmation of thromboangiitis obliterans by musculocutaneous biopsy. The involvement of small- and medium-sized arteries and also thrombophlebitis and phlebemphraxis were typical. Reliable diagnosis could have been considered when scintiangiography data that testified about the contraction or occlusion of distal arteries of extremities, and the results of biopsy were presented. Morphological substratum was a destructive-productive or productive thrombovasculitis of middleand small-sized arteries and veins. Necrotic destructive-infiltrative and destructive-proliferative arteriitis, accompanied by fibrinoid necrosis of the arterial wall and by its infiltration with neutrophils were revealed with the productive. The thromboses were revealed with these arteriitis more frequently, and in the wall of such arteries immune complexes were observed. Ischemic manifestations were connected not only with arterial stenosis, but also with microangiosclerosis. Differential diagnostic signs of atherosclerosis were represented. Involving of small- and middle-sized arteries was typical for thromboangiitis obliterans and large- and middle- sized arteries — for atherosclerosis. The thrombophlebitis and phlebothrombosis were characteristic for TAO. No specific laboratory tests were available to confirm TAO diagnosis. It should be noted the specific diagnostic tests and positive serological markers, characteristic for other SV nosologic forms were absent. Some questions of nosologic specification, pathogenesis and principles of therapy were discussed. It should also be noted that the spectrum of TAO interpretation changed since the beginning of the XXI century. The disease requires multidistsiplinary approach both in diagnostics and refinement of nosologic belonging, pathogenesis and designation of pathogenetic therapy.

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22

Kalinin, R. E., I. A. Suchkov, E. A. Klimentova, A. V. Shchulkin, A. S. Pshennikov, P. Yu Mylnikov, and A. A. Egorov. "Parameters of mitochondrial pathway of apoptosis in serum and homogenate of vascular wall in patients with atherosclerosis of peripheral arteries." NAUKA MOLODYKH (Eruditio Juvenium) 9, no. 2 (June 30, 2021): 226–34. http://dx.doi.org/10.23888/hmj202192226-234.

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Aim. Determination of the amount of Bcl2 and Bax apoptosis proteins in the homogenate of the vascular wall and blood serum, and of their relationship in patients with obliterating atherosclerosis of the lower limb arteries (OALLA) with III stage of the disease. Materials and Methods. The study included 12 patients with III stage OALLA according to Pokrovsky-Fontaine classification. After follow-up examination, these patients underwent open surgical interventions on the arteries of the femoral-popliteal segment. According to signed informed consent, during the surgical intervention, the intraoperative samples of all three layers of the vascular wall were taken. A sample of the vessel was crushed, and a homogenate was prepared, in which expression of Bcl2 anti-apoptotic protein and Bax pro-apoptotic protein was determined by ELISA method. Samples of the vascular wall without visible signs of atherosclerosis taken from patients undergoing reconstructive surgery were used as a control for arteries. Initially, before the operation, the studied parameters were determined in blood serum using ELISA method. To determine the reference values of Bcl2 and Bax proteins, healthy volunteers were included in the study. Results. In the homogenate of the arterial wall without atherosclerotic changes (control sample), the amount of Bcl2 protein was 1.26 ng/ml, of Bax 3.8 ng/ml. In the homogenate of the arterial wall in the area of an atherosclerotic plaque, the amount of Bcl2 did not differ from the control sample and was 1.4 ng/ml (p=0.504), and the amount of Bax protein increased to 6.54 ng/ml (p=0.033). In healthy volunteers, Bcl2 and Bax values in serum were 5.2 ng/ml and 15.9 ng/ml, respectively. In patients with OALLA, the amount of Bax protein in blood serum increased to 26.7 ng/ml (p=0.009), with the level of Bcl2 4.96 ng/ml (p=0.761). Correlation analysis showed the relationship between the level of Bcl2 (r=+0.806), Bax (r=+0.699), Вах/Всl2 (r=+0,642) in the homogenate of the vascular wall and in blood serum. Conclusions. In patients with III stage OALLA, the level of pro-apoptotic Bax protein was elevated both in the vascular wall and in the blood serum. The amount of Bcl2 and Bax apoptosis proteins in blood serum reflects their amount in the vascular wall in patients with OALLA.

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Spiridonova, Vera S., Rimma T. Sklyarenko, Oleg A. Churzin, Dmitry V. Antonov, and Magomed S. Omarov. "Possibilities of rehabilitation in atherosclerosis of arteries of the lower limbs in combination with diabetes." Medical and Social Expert Evaluation and Rehabilitation 24, no. 2 (November 26, 2021): 29–32. http://dx.doi.org/10.17816/mser75467.

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BACKGROUND: According to the World Health Organization, more than 17 million people die from cardiovascular diseases every year in the world. Coronary heart disease is the leading cause of death in industrialized countries. AIMS: To evaluate the immediate result of treatment by revascularization of the limb and organ-preserving surgical interventions for purulent-necrotic lesions of the feet, neuropathic form of diabetic foot with osteoarthropathy in chronic arterial insufficiency of the IV degree. MATERIAL AND METHODS: In the paper, the authors investigated possible treatments with different limb lesions in patients diagnosed with diabetes mellitus. Since in this disease there are complications on the cardiovascular system, most people are diagnosed with obliterating atherosclerosis, which leads to slow necrosis of the limbs. This causes diabetes patients, not only severe pain and an aesthetically unsightly state of the body, but also noticeably worsens the quality of life. RESULTS: With a consolidated approach to this problem, endocrinologists and cardiovascular surgeons developed and tested the method of endascular surgery. Patients diagnosed with obliterating lower extremity vascular atherosclerosis against the background of diabetes mellitus with trophic and necrotic lesions of the peripheral lower extremities underwent enduscular surgery to revascularize the limb, which showed not just positive immediate treatment results, but gave opportunities to preserve patients limbs. CONCLUSION: Timely recognition and treatment of purulent-necrotic lesions of the feet, the neuropathic form of diabetic foot with osteoarthropathy requires an interdisciplinary approach and close cooperation of doctors of different specialties - endocrinologists, surgeons, podiatrists, orthopedists, general practitioners, etc. Only if these conditions are met, it is possible to achieve significant success and minimize the number of irreversible deformities and amputations of the feet, the weighting of disability groups.

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Khokhlova, Olga I., Elena M. Vasilchenko, Vera V. Lyakhovetskaya, and Marina G. Zhestikova. "Results of wheelchair skills training among the disabled persons with lower limb loss of vascular origin." Medical and Social Expert Evaluation and Rehabilitation 24, no. 2 (November 26, 2021): 47–57. http://dx.doi.org/10.17816/mser70210.

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BACKGROUND: Wheelchair skills training is an essential part of rehabilitation of the disabled persons with lower limb amputation (LLA) due to peripheral artery disease (PAD). However, nowadays this issue is poorly addressed in our country, there are no standardized technologies. AIM: Investigation of dynamics of the extent of wheelchair usage among disabled persons with LLA due to PAD during adjustment to the wheelchair using the Wheelchair Skills Program (WSP, Canada). MATERIALS AND METHODS: Altogether, 350 patients with lower limb stump [unilateral tibial stump ― 116 (33.1%), hip stump ― 223 (63.7%), bilateral tibial stumps ― 6 (1.7%), hip stump ― 5 (1.4%)] were examined in clinical settings at the Federal State Budgetary Institution Novokuznetsk Scientific and Practical Centre for Medical and Social Expertise and Rehabilitation of Disabled Persons Ministry of Labour and Social Protection of the Russian Federation. Male ― 268 (76.6%), female ― 82 (23.4%). Mean age 63.10.52 years. Cause of LLA: obliterative PAD (lower limb atherosclerotic arterial disease) ― 226 (64.6%), type 2 diabetes mellitus ― 124 (35.4%). WSP effectiveness was assessed in 227 disabled persons. Wheelchair skills retention in 1.1 (0.591.87) years was assessed in 48 persons, 25 persons have undergone training second time. RESULTS: It was found that 86% of the disabled persons with LLA needed the wheelchair skills training. Upon the completion of the course the level of individual wheelchair skills was increased in all participants. This contributed to an increase in their activities and participation, which was indirectly evidenced by 1.8 fold increase in the proportion of those using the wheelchair outdoors by the time of second hospitalization. CONCLUSION: The program provides an individual approach to training, based on the results of a study of the initial level of proficiency in wheelchair skills, the wishes of the user himself, his physical, somatic and psychological condition. Thanks to this, novice users were able to master basic skills, and relatively experienced ones ― more complex, and thereby increase their level of safe use of the wheelchair, as well as the degree of independence and everyday activity, which can indirectly be evidenced by a significant increase in the share of wheelchair users outside the house.

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Belentsov, S. M. "VenaSeal for vertical veno-venous reflux elimination in patients with chronic venous disease." Ambulatornaya khirurgiya = Ambulatory Surgery (Russia) 18, no. 1 (June 8, 2021): 48–54. http://dx.doi.org/10.21518/1995-1477-2021-18-1-48-54.

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Introduction. Chronic venous disease significantly reduces quality of life and often leads to complications. The only way to eliminate hemodynamically significant blood flow disorders is the surgical method, incl. its latest modification is the VenaSeal.Objective of the study. To study the immediate and long-term results of the use of VenaSeal adhesive technology to obliterate the incompetent major saphenous veins, as well as the potential benefits in special groups of patients based on three-year experience in using VenaSeal Glue Procedure.Materials and methods. Over a 3-year period, we have treated 104 patients with VenaSeal. The average age was 59.6 ± 14.97 years, the CEAP class was 3.2 ± 1.09. 101 patients had varicose veins, in three cases - post-thrombotic. The intervention was performed on 117 incompetent main veins: GSV – 107, SSV – 10.Results and discussion. Clinical evaluation and ultrasound imaging of veins immediately after the intervention of vein occlusion throughout the intervention. There was no pronounced pain syndrome after surgery. Complications occurred in 3 patients in the form of chemical phlebitis. Long-term results up to 3 years were studied clinically and using ultrasound in 72 patients (76 veins): recanalization was noted in 2 GSV (2.6%), which in one case was accompanied by the formation of a recurrent varicose veins. To study the effect of VenaSeal on the quality of life in a comparative aspect, a non-randomized, single-center, open-label study was carried out; it included patients, incl. with GSV occlusion using RFA and EVLT. In the group of patients after VenaSeal, the quality of life indicators were better values. In addition, the absence of the need for elastic compression made the surgical treatment of patients with chronic venous disease and concomitant lesions of the peripheral arterial bed. In groups of elderly and senile patients, patients with weeping eczema, with obesity, additional advantages were found in the form of a decrease in the invasiveness of the intervention and the possibility of correcting reflux as a hemodynamic basis for the development of trophic disorders with the aim of their faster and more effective relief.Conclusions. Non-thermal obliteration of incompetent major saphenous veins using VenaSeal in varicose veins and post-thrombotic disease is highly effective: the immediate results assessed with clinical methods and using ultrasound duplex scanning confirmed the occlusion of the target vein in all cases. The study of long-term results revealed recanalization of two veins out of 76, which accounted for 2.6%.

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Bogachev, V. YU, B. V. Boldin, S. V. Rodionov, and P. YU Turkin. "Conservative treatment of chronic obliterating diseases of lower limb arteries." Ambulatory surgery: hospital-replacing technologies, no. 1-2 (June 20, 2018): 14–19. http://dx.doi.org/10.21518/1995-14772018-1-2-14-19.

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The incidence of peripheral arteries atherosclerosis varies in the general population between 3 to 10%, increasing to 15 to 20% in patients older than 70 years. Due to the high and constantly increasing prevalence, chronic obliterating diseases of lower limbs arteries (CODLLA) constitute an important medical and socioeconomic problem that cannot be solved only through wide introduction and application of various innovative surgical technologies. The fact is that even the most modern and knowledge-intensive surgical interventions do not exert a fundamental influence on the principles of the CODLLA pathogenesis. Moreover, there is no doubt that the success of arterial reconstruction and its prolongation are largely determined by adequate conservative treatment, the principles of which are discussed in this article.

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Kuroda, Satoshi, Kiyohiro Houkin, Hiroyasu Kamiyama, and Hiroshi Abe. "Effects of Surgical Revascularization on Peripheral Artery Aneurysms in Moyamoya Disease: Report of Three Cases." Neurosurgery 49, no. 2 (August 1, 2001): 463–68. http://dx.doi.org/10.1097/00006123-200108000-00039.

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Abstract OBJECTIVE AND IMPORTANCE The beneficial effects of surgical revascularization on rebleeding in moyamoya disease remain unclear. This report is intended to clarify the effects of surgical revascularization on peripheral artery aneurysms, which represent one of the causes of intracranial bleeding in moyamoya disease. CLINICAL PRESENTATION Findings for three female patients who experienced intracranial bleeding are presented. Cerebral angiography revealed that intracranial bleeding resulted from the rupture of peripheral artery aneurysms arising from dilated collateral vessels such as the lenticulostriate artery. INTERVENTION The patients successfully underwent superficial temporal artery-middle cerebral artery anastomosis combined with encephaloduromyoarteriosynangiosis. Angiography demonstrated obliteration of the peripheral artery aneurysms, together with the disappearance or decrease in caliber of the parent collateral arteries, after surgery. None of the patients experienced rebleeding during the follow-up period (up to 52 mo). CONCLUSION The results strongly suggest that surgical revascularization potentially improves cerebral circulation and decreases hemodynamic stress on collateral vessels, obliterating peripheral artery aneurysms.

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Fiessinger, J. N., M. Aiach, J. F. Vitoux, J. M. Pernes, M. Roncato, and J. C. Gaux. "Thrombolytic Treatment in Obliterative Arterial Disease." Pathophysiology of Haemostasis and Thrombosis 16, no. 3 (1986): 83–85. http://dx.doi.org/10.1159/000215371.

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Katorkin, S. E., E. P. Krivoshchekov, E. B. Elshin, and M. Yu Kushnarchuk. "The use of cilostazol in the treatment of patients with obliterating atherosclerosis on the background of diabetes mellitus." Meditsinskiy sovet = Medical Council, no. 14 (August 10, 2022): 24–31. http://dx.doi.org/10.21518/2079-701x-2022-16-14-24-31.

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Introduction. Symptomatic peripheral arterial disease (intermittent claudication) is the main cause of disability and loss of mobility in patients and thus has a significant negative impact on their quality of life. Conservative treatment of these patients should be aimed at improving local blood flow, tissue metabolism and blood rheology. Cilostazol is the only drug with a Class I (Evidence A) recommendation for the treatment of intermittent claudication.Objective. Тo evaluate the clinical efficacy and safety of the use of cilostazol in patients with a combination of obliterating atherosclerosis of the arteries of the lower extremities and diabetes mellitus.Materials and methods. In 2021–2022, 102 patients were treated. Men – 78, women – 24, the average age was 62 ± 2.8 years. All patients were prescribed basic treatment of atherosclerosis of the arteries against the background of diabetes mellitus. In the first group (n = 52), cilostazol was additionally prescribed 100 mg 2 times a day. In the second group (n = 50), pentoxifylline was additionally prescribed 600 mg 2 times a day. The severity of the pain syndrome, the pain-free walking distance, the maximum walkable distance, the change in the ankle-shoulder index and partial oxygen pressure in the capillary blood of the foot tissues, the presence of negative outcomes were assessed after 1, 3, 6 months of treatment.Results and discussions. In group 1 patients, a more pronounced decrease in pain syndrome was noted compared to group 2, both in patients with IIA degree and in patients with IIB degree of lower limb ischemia according to Fontaine. The increase in pain-free walking distance and the maximum walking distance in group 1 were more significant than in group 2, starting from the 3rd month of treatment. The ankle-brachial index practically did not change, both in group 1 and in group 2. Negative outcomes of treatment after 6 months in the 1st group – 1.9%, and in the 2nd group – 8%.Conclusions. If it is impossible to revascularize the limb in patients with obliterating atherosclerosis of the arteries on the background of diabetes mellitus, the inclusion of cilostazol in the treatment regimen shows better final results than the appointment of pentoxifylline. The use of cilostazol significantly improved the quality of life and functional ability of the lower extremities in patients with intermittent claudication.

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Tillgren, Carl. "Obliterative Arterial Disease of the Lower Limbs." Acta Medica Scandinavica 178, no. 1 (April 24, 2009): 103–19. http://dx.doi.org/10.1111/j.0954-6820.1965.tb04254.x.

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Tillgren, Carl. "Obliterative Arterial Disease of the Lower Limbs." Acta Medica Scandinavica 178, no. 1 (April 24, 2009): 121–28. http://dx.doi.org/10.1111/j.0954-6820.1965.tb04255.x.

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Tillgren, Carl. "Obliterative Arterial Disease of the Lower Limbs." Acta Medica Scandinavica 178, no. 2 (April 24, 2009): 203–19. http://dx.doi.org/10.1111/j.0954-6820.1965.tb04264.x.

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West, James, Anandharajan Rathinasabapathy, Xinping Chen, Sheila Shay, Shanti Gladson, and Megha Talati. "Overexpression of Msx1 in Mouse Lung Leads to Loss of Pulmonary Vessels Following Vascular Hypoxic Injury." Cells 10, no. 9 (September 3, 2021): 2306. http://dx.doi.org/10.3390/cells10092306.

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Pulmonary arterial hypertension (PAH) is a progressive lung disease caused by thickening of the pulmonary arterial wall and luminal obliteration of the small peripheral arteries leading to increase in vascular resistance which elevates pulmonary artery pressure that eventually causes right heart failure and death. We have previously shown that transcription factor Msx1 (mainly expressed during embryogenesis) is strongly upregulated in transformed lymphocytes obtained from PAH patients, especially IPAH. Under pathological conditions, Msx1 overexpression can cause cell dedifferentiation or cell apoptosis. We hypothesized that Msx1 overexpression contributes to loss of small pulmonary vessels in PAH. In IPAH lung, MSX1 protein localization was strikingly increased in muscularized remodeled pulmonary vessels, whereas it was undetectable in control pulmonary arteries. We developed a transgenic mouse model overexpressing MSX1 (MSX1OE) by about 4-fold and exposed these mice to normoxic, sugen hypoxic (3 weeks) or hyperoxic (100% 02 for 3 weeks) conditions. Under normoxic conditions, compared to controls, MSX1OE mice demonstrated a 30-fold and 2-fold increase in lung Msx1 mRNA and protein expression, respectively. There was a significant retinal capillary dropout (p < 0.01) in MSX1OE mice, which was increased further (p < 0.03) with sugen hypoxia. At baseline, the number of pulmonary vessels in MSX1OE mice was similar to controls. In sugen-hypoxia-treated MSX1OE mice, the number of small (0–25 uM) and medium (25–50 uM) size muscularized vessels increased approximately 2-fold (p < 0.01) compared to baseline controls; however, they were strikingly lower (p < 0.001) in number than in sugen-hypoxia-treated control mice. In MSX1OE mouse lung, 104 genes were upregulated and 67 genes were downregulated compared to controls. Similarly, in PVECs, 156 genes were upregulated and 320 genes were downregulated from siRNA to MSX1OE, and in PVSMCs, 65 genes were upregulated and 321 genes were downregulated from siRNA to MSX1OE (with control in the middle). Many of the statistically significant GO groups associated with MSX1 expression in lung, PVECs, and PVSMCs were similar, and were involved in cell cycle, cytoskeletal and macromolecule organization, and programmed cell death. Overexpression of MSX1 suppresses many cell-cycle-related genes in PVSMCs but induces them in PVECs. In conclusion, overexpression of Msx1 leads to loss of pulmonary vessels, which is exacerbated by sugen hypoxia, and functional consequences of Msx1 overexpression are cell-dependent.

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Prokhorova, O. O., and M. S. Brynza. "Silent myocardial ischemia in patients with type 2 diabetes mellitus: a clinical case." EMERGENCY MEDICINE 17, no. 4 (August 18, 2021): 39–42. http://dx.doi.org/10.22141/2224-0586.17.4.2021.237725.

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Background. Type 2 diabetes mellitus (DM) is an important medical, social, and economic problem due to the high prevalence of the disease, which often leads to disability and significantly increases mortality in elderly people. One of the causes of coronary heart disease (CHD) in patients with type 2 DM is autonomic cardiovascular neuropathy, which is characterized by damage to the autonomic nervous system and manifests itself in a varying clinical picture, including silent myocardial ischemia (SMI). The prevalence of SMI among patients with type 2 DM is much higher than in people without it. The purpose was to study the clinical case of a patient with type 2 DM and CHD, raise awareness of the prevalence and influence of type 2 DM on CHD progression by focusing on diagnostic research and treatment strategies. Materials and methods. The clinical case of the detected silent ischemia in a patient with type 2 DM was analyzed. The complaints were as following: high blood pressure, moderate shortness of breath during walking, pain, and numbness of the lower extremities. Anamnesis: type 2 DM over 20 years; endovascular stenting of the right common iliac artery due to obliterating atherosclerosis of the arteries of the lower extremities; hypertension over 10 years; obesity. Based on this data, CHD was suspected. Results. The Holter monitoring revealed rare episodes of reversible ischemic repolarization. ECG demonstrated the deviation of the electrical axis to the left, hypertrophy of the left ventricular myocardium, diffuse violation of repolarization processes. Ultrasound of the heart found aortic atherosclerosis, left ventricular myocardial hypertrophy, a moderate decrease in myocardial contractility. Ultrasound of vessels of the lower extremities showed the signs of obliterating atherosclerosis with decompensation of peripheral blood flow. Coronary angiography demonstrated left coronary artery with critical subocclusions (90 %), right coronary artery with chronic occlusion in the middle segment (100 %). There was established the diagnosis: coronary heart disease (silent ischemia); diffuse stenotic atherosclerosis of the coronary artery (coronary angiography May 2019); arterial hypertension II stage, degree 2; HF II stage; II NYHA; type 2 diabetes mellitus, insulin-dependent, decompensated; obesity I stage; obliterating atherosclerosis of the arteries of the lower extremities (condition after endovascular stenting of the right common iliac artery on January 2018); chronic pancreatitis in remission, peptic ulcer of the duodenum (operated in 1981); chronic cholecystitis in remission. The treatment was prescribed: insulin therapy, nebivolol, eplerenone, candesartan, clopidogrel, rosuvastatin. Coronary artery bypass grafting is recommended. Conclusions. Thereby, timely diagnosis and adequate treatment can avoid complications of type 2 DM and improve quality and lifetime. With type 2 DM, CHD is often masked and remains undiagnosed, leading to complications and death, therefore more attention to such patients is needed.

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Kruse, RR, EJ Vinke, FB Poelmann, D. Rohof, S. Holewijn, CH Slump, and MMPJ Reijnen. "Computation of blood flow through collateral circulation of the superficial femoral artery." Vascular 24, no. 2 (May 12, 2015): 126–33. http://dx.doi.org/10.1177/1708538115586939.

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Objective Obliteration of collaterals during (endo)vascular treatment of peripheral arterial occlusive disease is considered detrimental. We use a model to calculate maximum collateral bed flow of the superficial femoral artery in order to provide insight in their hemodynamic relevance. Method A computational model was developed using digital subtraction angiographies in combination with Poiseuille's equation and Ohm's law. Lesions were divided into short and long (<15 cm and ≥15 cm, respectively) and into stenosis and occlusions. Data are presented in relation to the calculated maximum healthy superficial femoral artery flow. Results Stenotic lesions are longer than occlusive lesions ( P < 0.05) and occlusions had more and larger collaterals ( P < 0.05). In all four study groups the collateral flow significantly increased the total flow ( P < 0.05). The maximum collateral system flow in the stenosis and occlusion groups was 5.1% and 20.8% of healthy superficial femoral artery flow, respectively ( P < 0.05), and there were no significant differences between short and long lesions (11.2% and 6.7% of healthy superficial femoral artery flow, respectively). Conclusion The maximum collateral system flow of the superficial femoral artery is only a fraction, with a maximum of one fifth, of healthy superficial femoral artery flow. Effects of collateral vessel occlusion during (endo)vascular treatment may therefore be without detrimental consequences.

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Nikulnikov, P. I., and A. V. Ratushnyuk. "Experience with pentotren in patients with obliterating peripheral arteries diseases." Surgery of Ukraine, no. 3 (September 19, 2018): 68–70. http://dx.doi.org/10.30978/su2018-3-68.

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Laine, Christine. "Peripheral Arterial Disease." Annals of Internal Medicine 146, no. 5 (March 6, 2007): ITC3. http://dx.doi.org/10.7326/0003-4819-146-5-200703060-01003.

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Federman, Daniel G., Jeffrey D. Kravetz, Dawn M. Bravata, and Robert S. Kirsner. "Peripheral arterial disease." Postgraduate Medicine 119, no. 2 (July 2006): 21–27. http://dx.doi.org/10.3810/pgm.2006.07.1746.

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Polak, Joseph F. "PERIPHERAL ARTERIAL DISEASE." Radiologic Clinics of North America 33, no. 1 (January 1995): 71–90. http://dx.doi.org/10.1016/s0033-8389(22)00563-2.

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Tzanis, George L. "Peripheral Arterial Disease." Annals of Internal Medicine 150, no. 1 (January 6, 2009): 64. http://dx.doi.org/10.7326/0003-4819-150-1-200901060-00026.

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HAYAT, ATIF SITWAT, MOHAMMAD ADNAN BAWANY, GHULAM HUSSAIN BALOCH, and NAILA Shaikh. "PERIPHERAL ARTERIAL DISEASE." Professional Medical Journal 19, no. 04 (August 7, 2012): 501–7. http://dx.doi.org/10.29309/tpmj/2012.19.04.2267.

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Background: The increase in prevalence of type 2 diabetes and its complications is alarming. The incidence of diabetic footulcers due to peripheral arterial disease, which leads to foot amputations far too often, is unacceptably high especially in developing countries.This study has been conducted to find out frequency and degree of peripheral arterial disease in type 2 diabetics having foot ulcers at tertiarycare settings in Abbottabad. Methods: This was a prospective descriptive study-being conducted at Northern Institue of Medical Sciences(NIMS) and Ayub teaching hospital Abbottabad from August 2009 to June 2010. Type 2 diabetics with non-healing foot ulcers lasting longer thanten days, were selected for this study by non-probability purposive sampling method. All study subjects have undergone for palpation ofperipheral arterial pulses in the lower limbs. Ankle-brachial index (ABI) is the ratio of the systolic blood pressure at the ankle to that in the arm.Peripheral arterial disease (PAD) was considered to be present if ABI was less than 0.90. It was further graded as mild, moderate and severeaccording to ABI values between 0.70-0.90, 0.50-0.69 and less than 0.49 respectively, as per recommendations of American DiabetesAssociation. Results: A total of 83 type 2 diabetics with foot ulcers were enrolled during eleven months period of this study. The mean age ofstudy subjects was 53.68±9.51 years. There were 33 (39.75%) males and 50 (60.24%) females with M to F ratio of 1:1.51. Mean duration ofdiabetes was 13.67±5.80 years (ranging from 9-23 years). Majority 57 (68.67%) of our patients were obese having poor glycemic control.Peripheral arterial disease has been found in 35(42.16%) patients, out of them 18(51.42%) had mild PAD as their ABI values remained between0.70-0.90, 15(42.85%) had moderate PAD due to their ABI values between 0.50-0.69 and 2 (5.71%) had severe PAD as their ABI values liebelow 0.49. Conclusions: Ankle-brachial index is a non-invasive, inexpensive and office-based diagnostic tool for peripheral arterial diseasein type 2 diabetics having foot ulcers, Healthcare professionals must be trained about early referral and regular feet care of these patients.

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Koh, Yong-Bok. "Peripheral Arterial Disease." Journal of the Korean Medical Association 46, no. 7 (2003): 636. http://dx.doi.org/10.5124/jkma.2003.46.7.636.

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Jain, Aman, and Katie Clamp. "Peripheral arterial disease." InnovAiT: Education and inspiration for general practice 12, no. 3 (January 17, 2019): 123–26. http://dx.doi.org/10.1177/1755738018817795.

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Peripheral arterial disease is a chronic condition that is increasingly encountered in primary care. Its symptoms not only affect the patient’s physical wellbeing, but also can have profound effects on mental health. With an ageing population, the prevalence of peripheral arterial disease is likely to increase. Early recognition and optimum medical management can minimise the progression of peripheral arterial disease, allowing patients to lead a pain-free life. This article aims to briefly summarise the common symptoms, suggest tools that can be used to aid diagnosis, and review the current literature on the management of peripheral arterial disease, including surgical options.

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Golomb, Beatrice A., Tram T. Dang, and Michael H. Criqui. "Peripheral Arterial Disease." Circulation 114, no. 7 (August 15, 2006): 688–99. http://dx.doi.org/10.1161/circulationaha.105.593442.

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CHOJNOWSKI, DONNA. "Peripheral arterial disease." Nursing Made Incredibly Easy! 3, no. 4 (July 2005): 4–17. http://dx.doi.org/10.1097/00152258-200507000-00001.

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&NA;. "Peripheral arterial disease." Nursing Made Incredibly Easy! 3, no. 4 (July 2005): 18. http://dx.doi.org/10.1097/00152258-200507000-00002.

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Vowden, K. R., and P. Vowden. "Peripheral arterial disease." Journal of Wound Care 5, no. 1 (January 2, 1996): 23–26. http://dx.doi.org/10.12968/jowc.1996.5.1.23.

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Paraskevas, Kosmas I., Debabrata Mukherjee, and Thomas F. Whayne. "Peripheral Arterial Disease." Angiology 64, no. 8 (December 4, 2012): 569–71. http://dx.doi.org/10.1177/0003319712466730.

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Akiyode, Oluwaranti, Tracy Thomas, Salome Weaver, and Sarah Sahraoui. "Peripheral Arterial Disease." Topics in Geriatric Rehabilitation 29, no. 3 (2013): 179–86. http://dx.doi.org/10.1097/tgr.0b013e31828aef5d.

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Krikorian, Raffi K., and James L. Vacek. "Peripheral arterial disease." Postgraduate Medicine 97, no. 6 (June 1995): 109–19. http://dx.doi.org/10.1080/00325481.1995.11946007.

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