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Yu, Shikai, and Carmel M. McEniery. "Central Versus Peripheral Artery Stiffening and Cardiovascular Risk." Arteriosclerosis, Thrombosis, and Vascular Biology 40, no. 5 (May 2020): 1028–33. http://dx.doi.org/10.1161/atvbaha.120.313128.
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The large elastic arteries fulfill an important role in buffering the cyclical changes in blood pressure, which result from intermittent ventricular ejection. With aging and accrual of cardiovascular risk factors, the elastic arteries stiffen, and this process holds a number of deleterious consequences for the cardiovascular system and major organs. Indeed, arterial stiffness is now recognized as an important, independent determinant of cardiovascular disease risk. Additional, important information concerning the mechanisms underlying arterial stiffening has come from longitudinal studies of arterial stiffness. More recently, attention has focused on the role of peripheral, muscular arteries in cardiovascular disease risk prediction and, in particular, the clinical consequences of reversal of the normal gradient of arterial stiffness between central and peripheral arteries, with aging and disease.
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Virtanen, Juha, Markus Varpela, Fausto Biancari, Juho Jalkanen, and Harri Hakovirta. "Association between anatomical distribution of symptomatic peripheral artery disease and cerebrovascular disease." Vascular 28, no. 3 (January 24, 2020): 295–300. http://dx.doi.org/10.1177/1708538119893825.
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Aim Peripheral arterial disease is frequently associated with significant atherosclerosis of other vascular beds. The aim of the present study was to investigate a possible association between peripheral arterial disease segment-specific disease burden and cerebrovascular disease. Methods Two-hundred and twenty-six patients with clinically symptomatic peripheral arterial disease from the prospective PureASO registry were followed up after revascularization. The breadth of peripheral arterial disease was quantified at the time patients entered the study. The segment-specific peripheral arterial disease burden was correlated to cerebrovascular disease and imaging findings during a five-year follow-up. Results At five years, cerebrovascular disease-free survival after lower limb revascularization was 31%. Patients with peripheral arterial disease involving the crural arteries had significantly more ischemic degenerative changes at brain imaging ( p = 0.031), whereas patients with aorto-iliac and femoropopliteal segment peripheral arterial disease had more significant (>50% uni- or bilaterally) internal carotid artery stenosis compared to patients with crural peripheral arterial disease ( p = 0.006). According to Cox regression analyses, crural arteries burden was associated with a significantly increased risk of mortality (adjusted HR 2.07, CI 95% 1.12–3.28, p = 0.021) and cerebrovascular events (adjusted HR 1.97, CI 95% 1.19–3.26, p = 0.008). Conclusions Present results suggest that atherosclerosis burden at different lower limb artery segments is associated with defined cerebrovascular disease. This further suggests that risk factors and pathophysiological mechanisms are congruent across particular vascular beds.
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Bez, Leonardo Ghizoni, and Túlio Pinho Navarro. "Study of carotid disease in patients with peripheral artery disease." Revista do Colégio Brasileiro de Cirurgiões 41, no. 5 (October 2014): 311–18. http://dx.doi.org/10.1590/0100-69912014005003.
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Objective: To study the stenosis of the carotid arteries in patients with symptomatic peripheral arterial disease.Methods: we assessed 100 consecutive patients with symptomatic peripheral arterial disease in stages of intermittent claudication, rest pain or ulceration. Carotid stenosis was studied by echo-color-doppler, and considered significant when greater than or equal to 50%. We used univariate analysis to select potential predictors of carotid stenosis, later taken to multivariate analysis.Results: The prevalence of carotid stenosis was 84%, being significant in 40% and severe in 17%. The age range was 43-89 years (mean 69.78). Regarding gender, 61% were male and 39% female. Half of the patients had claudication and half had critical ischemia. Regarding risk factors, 86% of patients had hypertension, 66% exposure to smoke, 47% diabetes, 65% dyslipidemia, 24% coronary artery disease, 16% renal failure and 60% had family history of cardiovascular disease. In seven patients, there was a history of ischemic cerebrovascular symptoms in the carotid territory. The presence of cerebrovascular symptoms was statistically significant in influencing the degree of stenosis in the carotid arteries (p = 0.02 at overall assessment and p = 0.05 in the subgroups of significant and non-significant stenoses).Conclusion: the study of the carotid arteries by duplex scan examination is of paramount importance in the evaluation of patients with symptomatic peripheral arterial disease, and should be systematically conducted in the study of such patients.
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Opincariu, Diana, András Mester, Imre Benedek, and István Benedek. "Stem Cell Therapies in Peripheral Vascular Diseases — Current Status." Journal of Interdisciplinary Medicine 2, s4 (December 1, 2017): 12–19. http://dx.doi.org/10.1515/jim-2017-0093.
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AbstractPeripheral artery diseases include all arterial diseases with the exception of coronary and aortic involvement, more specifically diseases of the extracranial carotids, upper limb arteries, mesenteric and renal vessels, and last but not least, lower limb arteries. Mononuclear stem cells, harvested from various sites (bone marrow, peripheral blood, mesenchymal cells, adipose-derived stem cells) have been studied as a treatment option for alleviating symptoms in peripheral artery disease, as potential stimulators for therapeutic angiogenesis, thus improving vascularization of the ischemic tissue. The aim of this manuscript was to review current medical literature on a novel treatment method — cell therapy, in patients with various peripheral vascular diseases, including carotid, renal, mesenteric artery disease, thromboangiitis obliterans, as well as upper and lower limb artery disease.
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Gajnitdinova, V. V., A. B. Bakirov, E. Kh Akhmetzyanova, N. F. Berdikaeva, and V. B. Zakirova. "Arterial stiffness of peripheral vasculature in patients with chronic obstructive pulmonary disease and its association with arterial hypertension." Kazan medical journal 94, no. 6 (December 15, 2013): 808–12. http://dx.doi.org/10.17816/kmj1795.
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Aim. To study the structural and functional state of vascular wall, arterial stiffness of large peripheral arteries (common carotid arteries, renal arteries) in patients with severe chronic obstructive pulmonary disease and its association with arterial hypertension. Methods. The study included 67 patients of working age, mainly males, having chronic obstructive pulmonary disease. Among them, 52 patients had severe chronic obstructive pulmonary disease (defined by GOLD III, 2011), 15 had concomitant arterial hypertension of I and II stage. Structural and functional status of common carotid arteries, renal arteries was assessed by measurement of intima-media thickness, arterial stiffness indexes were calculated. Arterial elasticity indices: arterial compliance, elastic index, Young’s elastic modulus were calculated based on the results of ultrasonography of main arterial wall parameters (diameter, arterial wall thickness) and blood pressure measurement. Results. A decrease in common carotid arteries and renal arteries wall elasticity was revealed in patients with chronic obstructive pulmonary disease. Increase of stiffness index in patients with severe chronic obstructive pulmonary disease associated with arterial hypertension, marking the decreased arterial wall elasticity, was registered both in common carotid arteries and renal arteries. Conclusion. In common carotid arteries vascular wall thickness contribute the most in vascular wall stiffness increase, compared to altered hemodynamics in renal arteries. Development of arterial hypertension in these patients is a predicting factor for further large vessel remodeling associated with hypoxia.
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Heinrich, Jürgen, Helmut Schulte, Rainer Schönfeld, Ekkehart Köhler, and Gerd Assmann. "Association of Variables of Coagulation, Fibrinolysis and Acute-phase with Atherosclerosis in Coronary and Peripheral Arteries and those Arteries Supplying the Brain." Thrombosis and Haemostasis 73, no. 03 (1995): 374–79. http://dx.doi.org/10.1055/s-0038-1653783.
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SummaryWe investigated the vessel status of coronary and peripheral arteries and those arteries supplying the brain in 929 consecutive male patients admitted to a coronary rehabilitation unit. The severity of coronary atherosclerosis was scored using coronary angiography. Changes in extracranial brain vessels and manifest cerebrovascular disease (CVD) were determined by B-mode ultrasound and Doppler examination. Peripheral arterial disease (PAD) was diagnosed using base-line and stress oscillography. We assessed variables of coagulation, fibrinolysis, and the acute phase response.There was a significant increase in plasma fibrinogen, plasminogen, d-dimer and C-reactive protein (CRP) with increasing severity of coronary heart disease. Compared to men with unaffected arteries, men with 3 diseased coronary arteries had 58% greater d-dimer concentrations. Patients with CVD and PAD, respectively, also had significantly higher fibrinogen, d-dimer and CRP concentrations. We did not find an association between plasminogen activator inhibitor activity and the severity of coronary atherosclerosis.In conclusion, plasma fibrinogen, d-dimer and CRP concentrations were significantly related to atherosclerosis in the coronary, peripheral and extracranial brain arteries.
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Denisenko, M. N., V. V. Genkel, and I. I. Shaposhnik. "Endothelial dysfunction in patients with hypertension and peripheral artery disease." Kazan medical journal 97, no. 5 (October 15, 2016): 691–95. http://dx.doi.org/10.17750/kmj2016-691.
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Aim. To assess endothelial function in patients with hypertension and peripheral artery disease.Methods. The study included 100 patients with an established diagnosis of essential hypertension. Ultrasonic duplex scanning of brachiocephalic arteries and lower limb arteries was performed. The functional state of the endothelium was evaluated using postocclusive reactive hyperemia test by D.S. Celermajer.Results. Atherosclerotic plaques in the carotid arteries were found in 71% of patients, in the lower limb arteries - in 60%. The combined affection of both vascular beds was diagnosed in 51% of patients. Endothelial dysfunction was found in 64% of patients. In patients with carotid arterial system atherosclerosis, brachial artery dilation response was 6.1%, while in those with intact carotid arteries - 4.7% (p=0.041). The value of the brachial artery dilation response in patients with atherosclerotic lesions of lower extremities arteries was 5.9%. In the subgroup of patients with intact lower limbs arteries, the increase in brachial artery diameter was 9.60% an average (p=0.04). Among 51 people with affection of both vascular systems the brachial artery diameter increase was 5.4%, while in comparison, in the subgroup consisting of 49 patients without combined carotid and lower limb arteries lesions, - 9.9% (p=0.003). According to the results of the correlation analysis, the relation between endothelial dysfunction and the maximum percentage of stenosis of the carotid arteries and lower limb arteries at the level of tibial segment was revealed.Conclusion. In patients with hypertension and peripheral artery disease, decrease in dilation response in endothelium-dependent vasodilation test was registered regardless of the localization of atherosclerotic lesions; endothelial dysfunction in essential hypertension was associated with the highest percentage of stenosis of the carotid arteries and lower limb arteries at the level of tibial segment.
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Catalano, Maria, Giovanni Scandale, Tao Jun, Marzio Minola, Martino Recchia, and Massimo Annoni. "Radial Artery Compliance in Patients with Peripheral Vascular Disease." Vascular Medicine 2, no. 1 (February 1997): 8–12. http://dx.doi.org/10.1177/1358863x9700200102.
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Compliance in largely central arteries of patients with peripheral vascular disease (PVD) has been reported to be reduced. However, the arterial tree is an inhomogeneous system, and there remains uncertainty about whether the peripheral arteries (e.g. the medium-sized muscular radial artery) undergo a similar change to the central arteries. The aim of this study was to investigate the radial artery elasticity in 19 patients with PVD compared with 18 normal subjects of comparable age and sex. Using a noninvasive high-resolution echo-tracking device coupled to a photoplethysmograph (Finapres system) allowing simultaneous arterial diameter and finger blood pressure monitoring, we measured the radial artery compliance by determining the diameter–pressure, compliance–pressure and distensibility–pressure curves. The results showed that the diameter of the radial artery was similar in the two groups, but that the compliance and distensibility were not further reduced in patients with PVD than in the normal controls at 100 mmHg and for a common blood pressure range. The present studies demonstrate that in patients with PVD the radial arterial compliance is not reduced, which indicates that the change in arterial elasticity is not identical. The potential mechanisms involved in this change in radial artery compliance are discussed.
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C., Prasad, and Santosh Nayak K. "Clinical study of peripheral arterial occlusive disease of lower extremities." International Surgery Journal 5, no. 4 (March 23, 2018): 1388. http://dx.doi.org/10.18203/2349-2902.isj20181116.
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Background: Peripheral arterial occlusive disease or commonly known as peripheral arterial disease (PAD) comprises those entities which result in obstruction to blood flow in the arteries, exclusive of the coronary and intracranial vessels and the term is usually applied to disease involving the arteries of lower extremity. Peripheral arterial disease is an important manifestation of atherosclerosis involving the arteries of legs. Vascular surgeons continue to encounter complications of atherosclerosis as their most common clinical challenge. Objective of this study was to know the various etiologies and different clinical presentation of Peripheral arterial occlusive disease.Methods: This was a cross sectional observational study of 50 cases diagnosed with Peripheral Arterial disease of the lower extremities, done during the period from January 2013 to June 2014 among the Patients with Peripheral Arterial disease of the lower extremities admitted to surgical wards of SCBMCH, Cuttack.Results: All the cases in the present study fall under the category of chronic lower limb ischemia and no cases of acute limb ischemia. Majority of the cases in atherosclerosis were above the age of 50 years, while in the TAO group majority belong to the age group between 31 to 50 years. TAO was usually limited to the distal part of the limb. All patients with TAO had a history of smoking and 61% of atherosclerotic patients gave history of smoking.Conclusions: TAO and Atherosclerosis are the etiologies for ischemia in these cases, with atherosclerosis being more common of the two. TAO presented at a younger age group whereas atherosclerosis presented in the older age group.
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Haider, Rehan. "Peripheral Vascular Disease." Cardiology Research and Reports 5, no. 4 (September 29, 2023): 01–13. http://dx.doi.org/10.31579/2692-9759/104.
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Peripheral vascular disease comprises diseases of the arteries and veins outside the thoracic region.: peripheral arterial disease (PAD), carotid artery disease (CAD), and aortic aneurysmatic disorder (AAA). Other rare manifestations of atherosclerotic disorders (e.g., renovascular high blood pressure, abdominal angina, and ischemia of the top extremity) were briefly noted. Special concerns in patients with diabetes are addressed in relevant sections; for instance, infection in an ischemic foot in an affected person with diabetes is described within the phase of critical limb ischemia. Atherosclerosis is the primary cause of peripheral arterial vascular ailments. It is vital to appreciate that the pathogenic mechanisms of clinical atherosclerosis are dual: chronic obstruction and biotic. The chronic obstructive mechanism is the primary purpose of lower limb ischemia, and in patients with diabetes, it is far more regularly preceded by a thrombotic occasion. An affected person with moderate clay diction abruptly studies significantly shortening of walking distance or surprising onset of rest ache. Alternatively, the seemingly wholesome character develops claudication. A coronary period heart attack or stroke in an affected person with claudication is also a thrombotic event in a patient with chronic obstructive disorder. In general, patients with diabetes greater frequently develop symptoms of atherosclerotic headaches, they do it at a younger age and it may be greater difficult to treat and feature greater headaches with treatment (in particular with invasive treatment.
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Habib, Aida, Giovanna Petrucci, and Bianca Rocca. "Pathophysiology of Thrombosis in Peripheral Artery Disease." Current Vascular Pharmacology 18, no. 3 (April 24, 2020): 204–14. http://dx.doi.org/10.2174/1570161117666190206234046.
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<P>Under physiological conditions, peripheral arteries release endogenous vascular-protective and antithrombotic agents. Endothelial cells actively synthesize vasoactive mediators, which regulate vascular tone and platelet reactivity thus preventing thrombosis. Atherosclerosis disrupts homeostasis and favours thrombosis by triggering pro-thrombotic responses in the vessels, platelet activation, aggregation as well as vasoconstriction, phenomena that ultimately lead to symptomatic lumen restriction or complete occlusion. <P> In the present review, we will discuss the homeostatic role of arterial vessels in releasing vascular-protective agents, such as nitric oxide and prostacyclin, the role of pro- and anti-thrombotic vascular receptors as well as the contribution of circulating platelets and coagulation factors in triggering the pro-thrombotic response(s). We will discuss the pathological consequences of disrupting the protective pathways in the arteries and the pharmacological interventions along these pathways.</P>
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Meloni, Marco, and Prashanth R. J. Vas. "Peripheral Arterial Disease in Diabetic Foot: One Disease with Multiple Patterns." Journal of Clinical Medicine 14, no. 6 (March 14, 2025): 1987. https://doi.org/10.3390/jcm14061987.
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Peripheral arterial disease (PAD) is a major complication in individuals with diabetes and is increasingly prevalent in those with diabetic foot ulcers (DFUs). Despite this, the characterisation of PAD in diabetic patients remains insufficiently refined, leading to suboptimal management and outcomes. This review underscores the necessity for a more nuanced understanding of PAD’s anatomical and biological aspects in diabetic patients. The distribution of atherosclerotic plaques varies significantly among individuals, influencing prognosis and treatment efficacy. We describe three key patterns of PAD in diabetes: pattern 1 PAD—below-the-knee (BTK) disease (with infrageniculate disease where present); pattern 2—below-the-ankle (BTA) disease; and pattern 3—small artery disease (SAD), each presenting unique challenges and require tailored therapeutic approaches. BTK PAD, characterised by occlusions in the anterior tibial, posterior tibial, and peroneal arteries, necessitates targeted revascularisation to improve foot perfusion. BTA PAD, involving the pedal and plantar arteries, is associated with higher risks of amputation and requires advanced revascularisation techniques. SAD, affecting the small arteries of the foot, remains an enigma and is challenging to treat with the current mechanical methods, highlighting the potential of autologous cell therapy as a promising alternative. A refined characterisation of PAD in diabetes is crucial for developing effective, individualised treatment strategies, ultimately improving patient outcomes, and reducing the burden of diabetic foot complications. In light of these complexities, it is incredulous that we often use a single term, “peripheral arterial disease”, to describe such a diverse array of disease patterns. This oversimplification can be perilous, as it may lead to inadequate therapeutic approaches and suboptimal patient care.
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Stoia, Oana, Ioan Manițiu, Ioan Bitea, Gabriela Eminovici, and Minodora Teodoru. "Risk Factors in Peripheral Artery Disease Associated with Coronary Artery Disease." Acta Medica Transilvanica 24, no. 4 (December 1, 2019): 31–33. http://dx.doi.org/10.2478/amtsb-2019-0009.
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Abstract Peripheral arterial disease (PAD) is a partial or complete occlusion of one or more arteries leading to a suppression of blood flow and ischemia. In the process of stenosis, numerous processes are described, among which, the most common being atherosclerosis, affecting the arteries of the inferior and coronary limbs. In the 60 patients investigated angio-coronarographically in the Emergency County Clinical Hospital of Sibiu with PAD, the prevalence of high blood pressure (HBP) and smoking was observed, among the risk factors, and 73.3% had one or more coronary lesions. The association of diabetes mellitus (DM) with PAD has shown an increase in the number of coronary lesions. There was also a strong positive correlation between the presence of left anterior descending artery (LAD) injuries and the stage of PAD regardless of other risk factors.
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Konijn, Louise C. D., Hendrik van Overhagen, Richard A. P. Takx, Pim A. de Jong, Hugo T. C. Veger, and Willem P. Th M. Mali. "CT calcification patterns of peripheral arteries in patients without known peripheral arterial disease." European Journal of Radiology 128 (July 2020): 108973. http://dx.doi.org/10.1016/j.ejrad.2020.108973.
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Ullah, Ikram, Sami Ullah, Salman Ahmad, Mohammad Asghar Khan, and Hikmat Ullah Jan. "Comparison of Angiographic Characteristics of Peripheral Arterial Disease between Diabetic and Non-Diabetics." Pakistan Journal of Medical and Health Sciences 16, no. 11 (November 30, 2022): 611–13. http://dx.doi.org/10.53350/pjmhs20221611611.
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Background and Aim: Several factors contribute to the poor outcomes of peripheral arterial disease (PAD). The current study examined the results of peripheral transluminal angioplasty (PTA) in diabetics and non-diabetics with peripheral arterial disease (PAD). Patients and Methods: This cross-sectional study was carried out on 136 peripheral arteries disease patients including 84 non-diabetic and 52 diabetics in the department of Cardiology, Hayatabad Medical Complex, Peshawar during the period from January 2022 to June 2022. This study included patients with PADs who had PTAs performed on their femoral, iliac, infrapopliteal, and popliteal arteries. Study protocol was approved by the research and ethical committee. Patient’s demographic details and medical history were recorded. SPSS version 26 was used for data analysis. Results: The overall mean age was 64.6 ± 10.51 years. Diabetic patients were compared with non-diabetic patients in terms of age (63.8±11.2 versus 65.4± 9.82 years), smoking history (80.7% vs. 46.4%), hypercholesterolemia (25.4% versus 31.9%), and ischemic heart disease (40.6% versus 36.5%). The frequency of hypertensive patients was higher 64.8% in diabetic patients against 40.6% in non-diabetic patients. In terms of arterial segment below the knee and profunda femoris, arterial disease had higher severity in diabetic patients. Diabetic patients were more susceptible to amputation (43.2% vs. 12%, OR=4.8, P=0.001) and had higher mortality (48.9% versus 23.8%). Conclusion: The present study found that higher prevalence of limb ischemia, amputation, and higher rates of restenosis following peripheral transluminal angioplasty was found in diabetic patients compared to non-diabetic patients. Diabetic patients had poor prognosis and worse arterial disease than non-diabetic patients. Keywords: Diabetic patients, Angiographic characteristics, Peripheral arteries disease.
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Croner, Roland S., Klaus Balzer, Vera Schellerer, Volker Müller, Anne Schlabrakowsi, Michael Stürzl, Elisabeth Naschberger, and Werner Lang. "Molecular characterization of peripheral arterial disease in proximal extremity arteries." Journal of Surgical Research 178, no. 2 (December 2012): 1046–58. http://dx.doi.org/10.1016/j.jss.2012.07.024.
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Mcallister, Hugh A. "An Overview of Human Arterial Pathology." Toxicologic Pathology 17, no. 1_part_2 (January 1989): 219–31. http://dx.doi.org/10.1177/019262338901700118.
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In this manuscript the pathology of human arterial disease, including diseases of the aorta, coronary arteries, and peripheral arteries, is reviewed. Common atherosclerotic-related lesions and varied forms of aortitis, arteritis, and dissecting aneurysms are described in terms of their gross and microscopic characteristics. In addition, rarer occurrences, such as congenital hypoplasia of the arteries, are mentioned. Finally, morphologic changes in blood vessels that have been affected by drugs or toxins are summarized.
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Bhaduri, J., M. Raisuddin, M. Sarmin, MZ Sayeed, and MN Islam. "Prevalence and pattern of lower limbs peripheral artery disease detected by Duplex ultrasonography in patients having coronary artery blockage." TAJ: Journal of Teachers Association 29, no. 2 (December 3, 2018): 62–65. http://dx.doi.org/10.3329/taj.v29i2.39110.
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Introduction : Atherosclerosis is a systemic disease which may affect coronary arteries, carotid arteries and peripheral arteries. Patients having coronary artery disease may also have lower limb peripheral arteries involvement due to atherosclerosis. This study is to see the prevalence and pattern of lower limb arteries involvement in patients having CAD.Methods: Duplex ultrasonic evaluation of peripheral arteries were done in 210 patients of CAD. Ultrasonic evaluation was done by B Mode image and on the basic of haemodynamic change.Result : Mean age of respondents was was 51.3 ± 10.4 years. 90% patient did not show any clinical sign or symptoms of PAD. 5.2% of patient has critical level of stenosis in one or multiple segments of lower limb arteries, 0.5 % patients had stenosis below the critical level. All the patients suffering from PAD were male patients. No statistical significant relation was found between occurrence of PAD and severity of CAD.Conclusion : Patient of CAD may have hidden PAD without any clinical presentation. Duplex ultrasonography can be a non invasive initial study to rule out the possibility of lower limb arterial insufficiency.TAJ 2016; 29(2): 62-65
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Sementsova, N. A., A. I. Chesnikova, V. A. Safronenko, and N. S. Skarzhinskaya. "Arterial stiffness in hypertensive patients with peripheral artery disease." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 28, no. 4 (July 7, 2022): 386–95. http://dx.doi.org/10.18705/1607-419x-2022-28-4-386-395.
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Objective. To identify features of arterial stiffness, to establish relationships with indicators of the daily blood pressure profile and peripheral artery disease in patients with hypertension (HTN) in combination with subclinical and manifested atherosclerotic lesions of the arteries of the lower extremities. Design and methods. 120 patients were divided into 3 groups: group 1-46 patients with HTN and clinically manifested AALE, group 2-39 patients with HTN and asymptomatic AALE, group 3-35 HTN patients without AALE. All patients underwent general clinical laboratory and instrumental research methods, including 24-hour blood pressure ambulatory monitoring (24h-ABPM) with the assessment of 24-hour blood pressure profile and arterial stiffness parameters, ultrasonic triplex scanning (USTS) of the arteries of the lower extremities. Statistical data processing was carried out using Microsoft Office Excel 16 (2015, Microsoft, USA), Statistica 10.0 (StatSoft, USA), IBM SPSS Statistica 26.0 (IBM, USA). Results. Higher values of pulse wave velocity (PWVao), augmentation index (AIx) and ambulatory arterial stiffness index (AASI) were found in the 1st group in comparison to the 2nd and 3rd groups (p < 0,05). Lower reflected wave transit time (RWTT) (119,5 [112;127] ms) was found in the 1st group (128 [122;132], p = 0,001 and 126 [121;129] ms, p = 0,03 in the 2nd and and 3rd groups, respectively) groups. The maximum rate of blood pressure increase (dP/dtmax) in patients of the 1st (550 [466;666] mm Hg/s) and 2nd (634 [511;695] mm Hg/s) groups was significantly lower than in patients of the 3rd group (655 [526;806] mm Hg/s, p < 0,05). A direct correlation was found between AASI values and SBP (r = 0,291, p = 0,049) and its variability (r = 0,301, p = 0,042), AASI and PBP (r = 0,518, p < 0,001), its variability (r = 0,596, r < 0,001) in group 1, as well as AASI and PBP (r = 0,514, p < 0,001) and PBP variability (r = 0,632, p < 0,001) in group 2. A correlation between AIx and the degree of stenosis (%) of the arteries of the lower extremities was found in patients with AH and AALE of varying severity (r = 0,310, p = 0,004). Conclusions. In patients with subclinical course of AALE, lower values of dP/dtmax in comparison with HTN patients without AALE indicate an increase in arterial stiffness at the initial stages of peripheral atherosclerosis. Clinically manifested atherosclerotic lesions of the arteries of the lower extremities in HTN patients are associated with a more pronounced increase in arterial stiffness, which contributes to a higher cardiovascular risk.
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Eichmann, Anne, and Isabelle Brunet. "Arterial Innervation in Development and Disease." Science Translational Medicine 6, no. 252 (September 3, 2014): 252ps9. http://dx.doi.org/10.1126/scitranslmed.3008910.
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Innervation of arteries by sympathetic nerves is well known to control blood supply to organs. Recent studies have elucidated the mechanisms that regulate the development of arterial innervation and show that in addition to vascular tone, sympathetic nerves may also influence arterial maturation and growth. Understanding sympathetic arterial innervation may lead to new approaches to treat peripheral arterial disease and hypertension.
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Ceasovschih, Alexandr, Victoriţa Șorodoc, Viviana Aursulesei, Dan Tesloianu, Irina M. Jaba, Corina Dima Cozma, Bogdan M. Mihai, et al. "Beyond the Arteries in Peripheral Artery Disease." Internal Medicine 15, no. 3 (July 1, 2018): 17–25. http://dx.doi.org/10.2478/inmed-2018-0018.
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AbstractObjectives. This study aimed to examine peripheral artery disease severity impact on psychological profile of arteriopathy patients.Material and methods. The prospective study included consecutive PAD patients admitted to the 2nd Department of Internal Medicine and the Department of Cardiology of the Emergency Clinical Hospital “Sf. Spiridon” Iasi, between January and September, 2017.Rezults. The group included 139 PAD patients, 80.6% male and 19.4% female, with an average age of 63.23±9.44 years. PAD stages have a very strong association with level of quality of life (p<0.0001). All Leriche-Fontaine classification categories were significantly associated with the depressive symptoms (p<0.0001). The stress level was moderate in stages IIA, IIB and III and extremely severe in the terminal stage. The prevalence of anxiety was lowest in incipient PADstages with the highest value in stage III.Conclusions. The fragment of the PhD study presented the psychological profile in the PAD staging and advocates a personalized, wide-ranging approach to the arteriopathy patient including pain and depressive-anxiety management, with amajor impact on the quality of life at terminal stages.
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London, Gerard M. "Arterial Stiffness in Chronic Kidney Disease and End-Stage Renal Disease." Blood Purification 45, no. 1-3 (2018): 154–58. http://dx.doi.org/10.1159/000485146.
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Accelerated ageing is observed in patients with chronic kidney disease (CKD)/end-stage renal disease. Premature vascular aging and arterial stiffening are the most characteristic features of this “progeria” that is already observed in those with the early stages of CKD. Aortic stiffening is associated with high characteristic impedance, left ventricular hypertrophy, decreased coronary perfusion, and is a strong prognostic marker of mortality and cardiovascular morbidity. With aging, the arterial stiffening is more pronounced in the aorta and central arteries than in peripheral conduit arteries. This leads to progressive decrease and inversion of the arterial stiffness gradient and systemic reflection coefficient, leading to less protection of the microcirculation in the event of high-pressure transmission towards it Arterial stiffening is multifactorial with systemic microinflammation being one of the most important associated factors primarily associated with vascular calcifications.
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Marques, Leonardo, Silke Hopf-Jensen, Michael Preiss, and Stefan Mueller-Huelsbeck. "An Update on Drug-eluting Technology in Peripheral Arteries to Treat Peripheral Arterial Disease." Heart International 15, no. 2 (2021): 73. http://dx.doi.org/10.17925/hi.2021.15.2.73.
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London, Gerard M., Michel E. Safar, and Bruno Pannier. "The Age–Stiffness Relationships of Elastic and Muscular Arteries in a Control Population and in End-Stage Renal Disease Patients." Kidney and Dialysis 3, no. 1 (January 3, 2023): 36–45. http://dx.doi.org/10.3390/kidneydial3010003.
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Arterial dysfunction is major risk factor for cardiovascular complications, and arterial stiffness is an independent risk factor in end-stage renal disease patients. As the distance from the heart increases, arterial stiffness (pulse wave velocity) becomes progressively more marked. This generates a centrifugal stiffness gradient, which leads to partial, continuous local wave reflections, which in turn attenuate the transmission of pulsatile pressure into the microcirculation, thus limiting the potentially deleterious outcomes both upstream (on the heart: left-ventricular hypertrophy and coronary perfusion) and downstream (on the renal and cerebral microcirculation: reduced glomerular filtration and impaired cognitive functions). The impact of arterial aging is greater on the aorta and central capacitive arteries, and it is characterized by a loss or reversal of the physiological stiffness gradient between central and peripheral arteries. Recently, however, in contrast to observations on the aorta, several studies have shown less pronounced, absent, or even negative associations between muscular peripheral arteries and age–stiffness relationships, which may be associated with a decrease in or reversal of the stiffness gradient. These findings point to a potential benefit of assessing the muscular peripheral arteries to predict the risk of cardiovascular disease and suggest that reversal of the stiffness gradient may be an independent risk factor for all-cause mortality.
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Bishop, Paul D., Lindsay E. Feiten, Kenneth Ouriel, Sean P. Nassoiy, Mircea L. Pavkov, Daniel G. Clair, and Vikram S. Kashyap. "Arterial Calcification Increases in Distal Arteries in Patients with Peripheral Arterial Disease." Annals of Vascular Surgery 22, no. 6 (November 2008): 799–805. http://dx.doi.org/10.1016/j.avsg.2008.04.008.
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Kumar, Rakesh, and Anil Taneja. "Role of multidetector computed tomography angiography in evaluation of peripheral arterial disease." International Journal of Research in Medical Sciences 8, no. 7 (June 26, 2020): 2437. http://dx.doi.org/10.18203/2320-6012.ijrms20202557.
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Background: Diagnostic imaging plays an important role in the evaluation of peripheral arterial disease. Many imaging modalities are available ranging from conventional modalities to the cross-sectional modalities like Doppler ultrasound, DSA, CT and MRI. The main principles of imaging are to characterize the all lesions detected including type of plaques, no. of lesions, length of stenosis, diameter of vessel in pre-stenotic and post-stenotic segments, degree of wall calcification, assisting in pretreatment planning with respect to route of access, selection of balloon and demonstrates size, extent, neck dimention, and presence of thrombosis in cases with aneurysm.Methods: A Cross-sectional observational study was done in 30 patients. Clinically suspected patients of peripheral arterial disease based on history, sign and symptoms and patients diagnosed with peripheral arterial disease on color doppler were included in our study. Both modalities were compared for detecting the occlusion and stenotic segments.Results: A total of 476 vessel segments were imaged by both modalities. When all arterial segments were considered, MDCTA detected stenosis or occlusion lesions in 30% of arterial segments, versus 18.8% compared to DUS. MDCTA showed 9.8% (95% CI:[4.3%, 15.3%]) more lesions than DUS when all arterial segments were considered together, 11.2% (95% CI: [2.7%, 22.1%]) more lesions when only the iliac arteries were compared, 9.1% (95% CI: [3.2%, 17.2%]) more lesions when only the femoropopliteal arteries were compared, 8.9% (95% CI: [1.5%, 16.3%]) more lesions when only infrapopliteal arteries were compared and 13% (95% CI: [2.6%, 25.4%]) more lesions when only the upper limb arterial segments were compared, (p <0.05 for all comparisons).Conclusions: MDCTA may be used as a screening tool in patients with peripheral arterial disease as it is a non-invasive and more accurate modality when compared to DUS and plays important role in management.
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Vucaj-Cirilovic, Viktorija, Olivera Nikolic, Kosta Petrovic, Mira Govorcin, Dusan Hadnadjev, and Sanja Stojanovic. "Basic characteristics of duplexsonographyin the assessment of lower limb arterial circulation." Medical review 59, no. 5-6 (2006): 287–90. http://dx.doi.org/10.2298/mpns0606287v.
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Introduction. Dulpex and color duplex ultrasonography of lower limb arteries are valuable non-invasive diagnostic methods in the pathology of vascular diseases and a major step in diagnostics and in follow-up of hemodynamic and morphologic characteristics. Color Duplex Sonography. The method consists of image analysis and analysis of Doppler information. Real-time-B mode is used to visualize the anatomy of blood vessels and other pathological lesions. Doppler information based on the Doppler effect determine the pulse wave i.e. the shape of flow velocity - hemodynamic characteristics. Spectral analysis is the most important element ofDoppler examination of the lower limb peripheral arteries. Based on the spectral analysis, there are four stages of lower limb arterial disease: normal findings - 1%-19% diameter reduction; medium stenosis - artery diameter reduction of 20%-49%; high level stenosis - artery diameter reduction of 50%-100%; occlusion - no flow detected within the imaged arterial segment. In the first place, both iliac arteries are examined, which is followed with femoral, popliteal and crural arteries. The examination of iliac arteries is carried out with a 3.5 MHz transducer, and other peripheral arteries of the lower limbs are examined with a 7,5 or 5 MHz transducer. Conclusion. Color Doppler is an extremely valuable diagnostic method in detecting pathology of the lower limb arteries. With high reliability level arterial insufficiency and pathological arterial segments are diagnosed by a duplex-Doppler. .
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Kuprina, Nadezhda I., Ekaterina V. Ulanovskaya, and Olga A. Kochetova. "Ultrasound features of peripheral angiodistonic syndrome of the upper extremities in vibration disease." Russian Journal of Occupational Health and Industrial Ecology 60, no. 11 (December 3, 2020): 815–17. http://dx.doi.org/10.31089/1026-9428-2020-60-11-815-817.
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Introduction. Vibration disease (VD) is an example of the most common pathology due to the systematic exposure of the worker to intense vibration with sufficient work experience, the main manifestation of which is peripheral angiodystonic syndrome. The aim of study was to learn the features of peripheral blood flow in the arteries of the forearm in vibration disease using the ultrasound method. Materials and methods. The radial and ulnar arteries in patients with vibration disease were examined by ultrasound in B- and PW-mode. These materials present the results of an ultrasound assessment of the speed indicators of the main arteries of the forearm in vibration disease stages 1 and 2. The selection criteria for patients in the study ware the presence of pronounced clinical manifestations of angiodystonic syndrome in vibration disease, confirmed by instrumental research methods and data on the sanitary and hygienic characteristics of working conditions, the absence of cardiovascular chronic diseases (ischemic heart disease, heart defects, rhythm and conduction disturbances), rheumatic, oncological, infectious diseases, osteo-traumatic changes in the upper extremities. Results. The groups of patients with the established diagnosis of vibration disease of 1 and 2 degrees were studied. With vibration disease stage 1 a decrease in the pulse velocity of blood flow was observed in isolation on the ulnar artery and an increase in peripheral resistance (pulsation index and resistance index) in the radial and ulnar arteries symmetrically on both upper extremities. The second stage of vibration disease differed from the first by a more significant decrease in speed indicators both on the ulnar and radial arteries on both sides, symmetrically in combination with a more pronounced increase in peripheral resistance indicators on both main arteries of the forearm (pulsation index and resistance index). The revealed changes were determined with the same frequency in men and women. Conclusions. A significant decrease in speed indicators on the ulnar artery and an increase in peripheral resistance indicators are detected already at the initial stages of vibration disease. Thus, the method of ultrasound examination of the main arteries of the middle caliber of the upper extremities is currently the only available and objective method for examining the vascular system in vibration disease.
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Marwaha, T. S., G. Jain, A. Khurana, P. S. Dhoat, and B. Kumar. "Peripheral Vascular Disease a Silent Assassin:Rising Trend in State of Punjab." International Journal of Medical and Dental Sciences 2, no. 2 (July 1, 2013): 189. http://dx.doi.org/10.19056/ijmdsjssmes/2013/v2i2/86781.
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Peripheral vascular disease is a major macrovascular complication of diabetes mellitus. This study was done to determine the prevalence of peripheral arterial disease in type 2 diabetes mellitus using the ankle brachial pressure index. An 12 MHz doppler probe was used in the arms and legs to assess the ankle brachial index (ABI) in 200 type 2 diabetes mellitus patients aged more than 40 years. Thorough history of patients including age, smoking history, history of symptoms of peripheral arterial disease, complete physical examination and routine investigations were collected at the time of enrolment for all subjects. A ratio of the highest blood pressure from the posterior tibial or pedal arteries of each leg to the highest blood pressure from the brachial arteries < 0.9 was considered abnormal. Abnormal ABIs were found in 33% (66/200) patients with type 2 diabetes mellitus. 45.5% patients had ABI 0.80-0.89, 33.3% patients had ABI 0.50-0.79 and 21.2% patients had ABI <0.5 Prevalence of peripheral vascular disease in type 2 diabetes mellitus is on rise in northern India so there is need to educate the patients regarding risk factor modification and importance of early intervention to prevent future progression of peripheral vascular disease.
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Harms, Jonathan, Audrey J. Stone, and Marc P. Kaufman. "Peripheral µ-opioid receptors attenuate the responses of group III and IV afferents to contraction in rats with simulated peripheral artery disease." Journal of Neurophysiology 119, no. 6 (June 1, 2018): 2052–58. http://dx.doi.org/10.1152/jn.00034.2018.
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Patients with peripheral artery disease show an exaggerated pressor response to mild exercise, an effect attributable to the exercise pressor reflex, whose afferent arm comprises the thinly myelinated group III and unmyelinated group IV afferents. Previously, we found that DAMGO, a µ-opioid agonist injected into the femoral artery, attenuated the exaggerated exercise pressor reflex in rats with ligated femoral arteries, a preparation that simulates the blood flow patterns to muscle that is seen in patients with peripheral artery disease. Continuing this line of investigation, we recorded the responses of group III and IV afferents to static contraction before and after injecting DAMGO (1 µg) into the superficial epigastric artery in rats with patent femoral arteries and in rats with ligated femoral arteries. In rats with patent arteries, DAMGO did not change the responses to contraction of either group III ( n = 9; P = 0.83) or group IV ( n = 8; P = 0.34) afferents. In contrast, in rats with ligated femoral arteries, DAMGO injection (1 µg) significantly decreased the responses to contraction of both group III afferents ( n = 9, P < 0.01) and group IV afferents ( n = 9; P < 0.01). DAMGO did not significantly attenuate the responses of either group III or IV afferents to capsaicin in rats with either patent or ligated femoral arteries. These findings are in agreement with our previous studies that showed that peripheral DAMGO injection attenuated the exercise pressor reflex in rats with ligated femoral arteries but had only a modest effect on the exercise pressor reflex in rats with patent femoral arteries. NEW & NOTEWORTHY In an animal model of peripheral artery disease, we show that the µ-opioid agonist, DAMGO reduces the afferent response rate resulting from stimulated static contraction. These results suggest that peripherally active opioid agonists that do not cross the blood-brain barrier may be therapeutic for treatment of peripheral artery disease without the negative and addictive side effects associated with opioids in the central nervous system.
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Bokeria, L. A., V. S. Arakelyan, V. G. Papitashvili, and Sh Sh Tsurtsumiya. "Limb Revascularization in Patients with Diabetes Mellitus." RUDN Journal of Medicine 23, no. 4 (December 15, 2019): 349–63. http://dx.doi.org/10.22363/2313-0245-2019-23-4-349-363.
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The review describes morbidity, mortality and possible complication rates for diabetic patients with peripheral arteries disease. The article demonstrates the modern tendency in the surgical treatment of peripheral arteries atherosclerosis, shows and compares worldwide results of endovascular and open revascularization. The authors have assessed the risk of amputation for patients with diffuse peripheral arteries disease and described basic treatment principals for better chronic ischemic ulcer healing.
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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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Signorelli, Salvatore Santo, Luca Vanella, Nader G. Abraham, Salvatore Scuto, Elisa Marino, and Petra Rocic. "Pathophysiology of chronic peripheral ischemia: new perspectives." Therapeutic Advances in Chronic Disease 11 (January 2020): 204062231989446. http://dx.doi.org/10.1177/2040622319894466.
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Peripheral arterial disease (PAD) affects individuals particularly over 65 years old in the more advanced countries. Hemodynamic, inflammatory, and oxidative mechanisms interact in the pathophysiological scenario of this chronic arterial disease. We discuss the hemodynamic, muscle tissue, and oxidative stress (OxS) conditions related to chronic ischemia of the peripheral arteries. This review summarizes the results of evaluating both metabolic and oxidative markers, and also therapy to counteract OxS. In conclusion, we believe different pathways should be highlighted to discover new drugs to treat patients suffering from PAD.
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Broseta, Jaime, José Barberá, J. A. de Vera, Juan Luis Barcia-Salorio, Guillermo Garcia-March, José González-Darder, Francisco Rovaina, and Vicente Joanes. "Spinal cord stimulation in peripheral arterial disease." Journal of Neurosurgery 64, no. 1 (January 1986): 71–80. http://dx.doi.org/10.3171/jns.1986.64.1.0071.
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✓ Percutaneous epidural Stimulation of the low thoracic spinal cord was carried out in 41 patients with pain from peripheral arterial disease of the lower limbs. Results are reported relating to pain, claudication distance, peripheral blood flow, and trophic lesion changes. Following a trial period of stimulation, 37 patients had stimulators permanently implanted. After a mean poststimulation follow-up period of 25 months, substantial pain relief (75% to 100%) was obtained in 29 cases; claudication distance significantly increased in 15 cases; Doppler ultrasound recordings of lower-limb distal arteries showed a tendency toward normalization of pulse-wave morphology, with increase of amplitude in 12 of the 23 patients studied; a rise in skin temperature was also detected by thermography. Distal arterial blood pressure remained unchanged with stimulation. Ischemic cutaneous trophic lesions of less than 3 sq cm healed, but gangrenous conditions were not benefited. A placebo effect or the natural history of the disease can be excluded as the reason for these improvements. It is concluded that spinal cord stimulation is a valid alternative treatment for moderate peripheral arterial disorders when direct arterial surgery is not possible or has been unsuccessful.
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Stoia, Oana, Ioan Manițiu, Ioan Bitea, Mihaela Racheriu, and Gabriela Eminovici. "Comprehensive Analysis of Invasive and Noninvasive Investigation Methods in Peripheral Artery Disease." Acta Medica Transilvanica 24, no. 4 (December 1, 2019): 37–39. http://dx.doi.org/10.2478/amtsb-2019-0011.
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Abstract Peripheral artery disease of the lower limbs is, in fact, an arterial pathology, by which the blood flow is reduced, due to the obstruction caused by the deposit of atheroma plaques.(1) This deposition occurs slowly, which leads to a slow progression of the disease, and thus, at the onset of symptomatology. The objective of the study was to make a comparison between the invasive and noninvasive paraclinical investigations performed in patients with peripheral arterial disease of the lower limbs in the E.C.C.H. Sibiu. In conclusion, between the two investigations (computed tomography angiography and digital subtraction angiography) there are no noticeable differences in the terminal aorta and iliac arteries, but in reducing the arteries calibre, the use of digital subtraction angiography is preferred, according to our study, although it is more invasive and exposed to complications.
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Kelemen, Piroska, Beáta Katalin Kolbert, Mónika Szabó, Hanga Kelemen, Achim Radu, and Alwina Ana Stan. "Plurivascular Lesions in Patients with Peripheral Arterial Disease." Journal of Interdisciplinary Medicine 1, no. 2 (September 1, 2016): 173–79. http://dx.doi.org/10.1515/jim-2016-0040.
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AbstractIntroduction:Occlusive arterial disease, regardless of etiology, is a progressive chronic disease with multiple vessel involvement. The importance of obstructive arterial disease is that it leads to an increased mortality and morbidity of other cardiovascular disorders. Therefore, the presence of a lesion on a certain artery should lead to the identification of other lesions on the carotid and coronary arteries. The aim of the study was to assess the frequency and severity of lesions in peripheral arterial disease of different etiologies, and also to study its association with multivessel lesions at the level of the coronary tree and the carotid arteries.Material and methods:We performed a retrospective study on 177 patients with previously diagnosed peripheral artery disease that were admitted to the 2ndMedical Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș. The patients underwent evaluation of the peripheral artery disease (clinical, arterial Doppler), as well as of the coronary artery disease (clinical, ECG) and the carotid arteries (auscultation, Doppler Duplex ultrasound). The study population was divided into three groups: group 1 – diabetic arteriopathy (n = 79); group 2 – atherosclerotic obstructive arteriopathy (n = 77); group 3 – thromboangiitis obliterans (n = 21).Results:The patients' age ranged between 61 and 70 years. Arterial occlusions were found in 87% of cases in group 1. Suboclussions were more frequent in diabetics (11.4%). The artery, in which we found lesions in the highest percentage was the left femoral artery (group 1 – 68.3%, group 2 – 66.23%, group 3 – 42.85%). The second most often affected artery was the right femoral artery, with a 64.45% rate of involvement. In patients with thromboangiitis obliterans, the right anterior tibial artery was the most frequently affected (15.81%). The most frequent coronary lesion was a stenosis of 30–69%, in 35.02% of cases. Three-vessel coronary disease had an incidence of 44.2% in the atherosclerotic group, 34.2% in diabetics, and 23.8% in the thromboangiitis group. From the total rate of previously diagnosed myocardial infarction (MI) – 29.37% (n = 52), 50% were atherosclerotic, 44.23% diabetic, and 5.76% with thromboangiitis. At the level of the carotid system, 68.9% of patients were found to have stenoses under 70%. From these, 48.4% were patients with diabetic arteriopathy, 44.3% with atherosclerotic disease. In 73.4% of cases, we found lesions at all three levels — in case of diabetic and nondiabetic arteriopathy and thromboangiitis, only 14.3% of patients had associated lesions.Conclusions:Atherosclerosis (diabetic and nondiabetic) and thromboangiitis obliterans are diseases with plurivascular involvement. It is important to diagnose concomitant coronary and carotid lesions in patients with chronic occlusive arterial illness, because they are often associated.
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Karadeniz, Muhammed, and Çağlar Alp. "Peripheral arterial disease: a single center experience." Journal of Radiology in Medicine 1, no. 4 (October 30, 2024): 73–76. http://dx.doi.org/10.51271/jrm-0019.
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Aims: Angiography and interventional treatment modalities in peripheral arterial disease have recently been widely used because they are easier to perform and more comfortable than surgical treatment. Revascularization is the most effective treatment method in cases such as critical leg ischemia in this disease where pharmacological agents are also widely used. In this study, we aimed to investigate interventional treatment methods in peripheral arterial disease in our center. Methods: Patients who underwent peripheral angiography or endovascular intervention in the Cardiology Clinic of Kırıkkale University Medical Faculty Hospital between March 2020 and June 2024 were retrospectively reviewed. Results: A total of 55 patients, including 10 women and 45 men, were included in the study. The mean age of the patients included in the study was 64 years. Of the angiographic procedures, 46 were performed in the lower extremity, 6 in the upper extremity and 3 in the renal arteries. Endovascular treatment were performed in 26 of them. Of the endovascular treatment, 11 were balloon angioplasty and 15 were stent implantation. In 5 patients, peripheral bypass was decided. Conclusion: Interventional treatment of peripheral arterial disease is increasingly and successfully performed in our center.
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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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Jakubiak, Grzegorz K., Natalia Pawlas, Grzegorz Cieślar, and Agata Stanek. "Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes." International Journal of Environmental Research and Public Health 17, no. 24 (December 14, 2020): 9339. http://dx.doi.org/10.3390/ijerph17249339.
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Diabetes mellitus is an important risk factor for the development of cardiovascular diseases. Peripheral arterial disease affecting lower limb arteries is one of the clinical manifestations of atherosclerosis. The frailty syndrome (Frailty) is a problem associated with diminution of physiological reserves. The ankle-brachial index is a commonly used tool for diagnosing peripheral arterial disease (PAD). The usefulness of the ankle-brachial index (ABI) is limited in people with diabetes because of calcification of the middle layer of arteries. In this population, toe-brachial index should be measured. Frailty may be associated with worse prognosis for patients undergoing revascularization. Amputation may be an important factor leading to the development of Frailty. The risk of amputation and the prognosis after revascularization may be modified by some medications and blood glucose levels. The purpose of this paper is to review the literature about the association between PAD, especially in patients living with diabetes and Frailty.
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Hu, Lefan, and Hui Wang. "Clinical challenges in asymptomatic chronic aortoiliac occlusive disease." Vascular Investigation and Therapy 7, no. 2 (April 2024): 43–46. http://dx.doi.org/10.4103/vit.vit_23_24.
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Asymptomatic aortoiliac occlusive disease, while less common compared to other peripheral arterial diseases, presents unique clinical challenges. Our center recently encountered a case involving a patient with chronic occlusion of the distal abdominal aorta and bilateral iliac arteries. Remarkably, this patient had developed an extensive network of collateral circulation, effectively compensating for the reduced blood supply to the pelvic and lower limb areas. This adaptive physiological response resulted in the patient exhibiting no significant clinical symptoms. To reveal the most effective diagnostic and treatment strategies for asymptomatic peripheral artery disease patients to avoid complications and other challenges, more clinical studies are needed in the future.
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Scheller, Bruno, Bodo Cremers, Stephanie Schmitmeier, Beatrix Schnorr, Yvonne Clever, and Ulrich Speck. "Drug-coated Balloons – History and Peripheral Vascular Opportunities." Interventional Cardiology Review 5, no. 1 (2010): 70. http://dx.doi.org/10.15420/icr.2010.5.1.70.
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One of the most innovative fields of modern medical research is the percutaneous transluminal treatment of vascular disease. During recent decades considerable advances have been made in intravascular interventions for the treatment of coronary and peripheral arterial disease. Despite these advances, the long-term outcome remains an area of concern in many applications. Restenosis is still a challenge in endovascular medicine and has thus been referred to as the Achilles’ heel of percutaneous intervention. Therefore, novel strategies have been developed to overcome this problem. These include drug-eluting stents and the more recently introduced non-stent-based local drug delivery systems (in particular the drug-coated balloon). Results from several pre-clinical and clinical studies indicate that short-term exposure of injured arteries to paclitaxel delivered from regular angioplasty balloons may be sufficient to reduce late lumen loss and restenosis rates during a critical period of time after the angioplasty of diseased coronary and peripheral arteries. Although the number of published trials and patients treated is still limited, data available seem to prove that restenosis inhibition by immediate drug release is feasible. This article reviews the history of the drug-coated balloon and then focuses on peripheral artery trials.
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Okada, Masayoshi, Masato Yoshida, and Yoshihiko Tsuji. "Clinical Experience of Laser Angioplasty for the Cardiovascular Disease." Diagnostic and Therapeutic Endoscopy 2, no. 1 (January 1, 1995): 11–18. http://dx.doi.org/10.1155/dte.2.11.
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In recent years, lasers are being utilized in cardiovascular surgery. Since the 1980's we have investigated angioplasty using an Argon laser for patients with obstructive arterial diseases. This technique aims to open the obstructive arterial lumen. Based on the excellent results of experimental studies, the technique has been clinically applied. Laser angioplasty was carried out in 84 patients with stenotic or obstructive lesions occluding more than 75% of peripheral and coronary arteries angiographically. They consisted of 74 cases with intermittent claudication and 10 cases with angina pectoris. Laser angioplasty for the peripheral arterial disease was performed under local anesthesia in the inguinal region under angioscopic guidance. On the other hand, laser coronary angioplasty was simultaneously undertaken at the time of coronary artery bypass grafting for a patient with multiple coronary stenoses. The initial success rate by laser angioplasty for the peripheral artery was 91% in the stenotic lesions and 71% in the obstructive lesions. The cumulative patency rate was 94% in the stenotic lesions and 83% in the occlusive lesions. A follow-up study of 66 months was carried out for patients with clinical success, excluding the cases where an angiogram showed occlusion within 1 week after laser angioplasty. Consequently, excellent long-term results could be clinically obtained. Based on the satisfactory results in the peripheral artery, coronary laser angioplasty was employed in 10 patients with angina pectoris. There were no complications by laser. Thus, the feasibility of laser application was apparently confirmed and laser angioplasty might be recommended for patients with atherosclerotic changes, especially for small arteries.
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Zgouras, Engels, and Lindhoff-Last. "Lymphoplasmacytic lymphoma with Waldenstrom’s macroglobulinemia as a reason for peripheral arterial perfusion disorders." Vasa 38, no. 2 (May 1, 2009): 193–96. http://dx.doi.org/10.1024/0301-1526.38.2.193.
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Peripheral arterial perfusion disorders are often caused by embolism and thrombosis induced by diseases of the cardiovascular system. We report about a case of a 42-year-old female with peripheral arterial perfusion disturbances of the digital arteries caused by Waldenstrom´s disease due to high plasma viscosity. Our patient presented with elevated plasma viscosity (1.34 mPA) and therefore plasmapheresis was necessary. Plasma seperation is the most effective acute treatment for symptomatic hyperviscosity syndrome. In a second step patients with clinical symptoms of M. Waldenstrom have to be treated by chemotherapy.
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Meloni, Marco, Valentina Izzo, Laura Giurato, Valerio Da Ros, Daniele Morosetti, Michele Ferrannini, Enrico Brocco, Roberto Gandini, and Luigi Uccioli. "Peripheral arterial disease in patients with renal-diabetic foot ulcers." Journal of Wound Care 30, no. 8 (August 2, 2021): 660–64. http://dx.doi.org/10.12968/jowc.2021.30.8.660.
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Objective: To describe the angiographic characteristics of peripheral arterial disease (PAD) in persons with diabetic foot ulcers (DFUs) on dialysis treatment. Method: The study is a retrospective analysis of patients with DFUs and PAD who had been referred to our diabetic foot clinic. All patients had been managed by a pre-set limb salvage protocol including revascularisation of the affected limb. Arterial lesions (stenosis between 50–99% and occlusions) were retrospectively evaluated through angiogram analysis. According to the presence or not of dialysis, patients were divided into two patient groups: renal-diabetic foot (RDF) and diabetic foot (DF). Distribution of PAD and immediate revascularisation outcome (technical revascularisation outcome) for RDF and DF were separately reported and compared. Results: The sample included 239 patients: mean age was 71.8 years; 72.4% were male; 87.4% had type 2 diabetes; mean diabetes duration was 21.4 years; and the mean HbA1c was 63±22mmol/mol. The RDF group compared with the DF group reported higher numbers of vessels affected (n=5±1.6 versus 3.9±1.5, respectively, p<0.0001), greater involvement of the superficial femoral artery (90.2% versus 75.8%, respectively, p=0.003), the tibial-peroneal trunk (53.7% versus 25.5%, respectively, p=0.01), the anterior tibial artery (93.9% versus 80.9%, respectively, p=0.03) and below-the-ankle (BTA) arteries (70.7% versus 35.7%, respectively, p=0.0001). The RDF group showed a higher rate of revascularisation failure in comparison to DF patients (43.9% versus 15.3%, respectively, p<0.0001). BTA arterial disease (odds ratio 9.5; 95% Confidence Interval: 3.5–25.4; p=0.0001) resulted as the only independent predictor of revascularisation failure. Conclusion: In this study, RDF patients showed a widespread distribution of arterial lesions with a higher involvement of foot arteries in comparison with DF patients. BTA arterial disease was found to be an independent predictor of revascularisation failure.
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Ismaeel, Ahmed, Robert Brumberg, Jeffrey Kirk, Evlampia Papoutsi, Patrick Farmer, William Bohannon, Robert Smith, Jack Eidson, Ian Sawicki, and Panagiotis Koutakis. "Oxidative Stress and Arterial Dysfunction in Peripheral Artery Disease." Antioxidants 7, no. 10 (October 19, 2018): 145. http://dx.doi.org/10.3390/antiox7100145.
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Peripheral artery disease (PAD) is an atherosclerotic disease characterized by a narrowing of the arteries in the lower extremities. Disease manifestations are the result of more than just reduced blood flow, and include endothelial dysfunction, arterial stiffness, and inflammation. Growing evidence suggests that these factors lead to functional impairment and decline in PAD patients. Oxidative stress also plays an important role in the disease, and a growing amount of data suggest a link between arterial dysfunction and oxidative stress. In this review, we present the current evidence for the involvement of endothelial dysfunction, arterial stiffness, and inflammation in the pathophysiology of PAD. We also discuss the links between these factors and oxidative stress, with a focus on nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2)-derived reactive oxygen species (ROS) and decreased nitric oxide (NO) bioavailability. Finally, the potential therapeutic role of NOX2 antioxidants for improving arterial function and functional status in PAD patients is explored.
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DIACONU, Camelia, Irina CRÎȘMARU, Giorgiana DEDIU, and Alice BĂLĂCEANU. "Peripheral artery disease – necessary steps for keeping us walking." Romanian Journal of Medical Practice 10, no. 3 (September 30, 2015): 240–45. http://dx.doi.org/10.37897/rjmp.2015.3.4.
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Peripheral arterial disease (PAD) is a consequence of the atherosclerosis of large arteries located distal to aortic arch. The most common symptom is intermittent claudication. The most commonly used screening tool of BAP in primary care is the ankle-brachial index (ABI), especially recommended for patients older than 70 years or between 50-69 years, if they are diabetics or smokers. Management of PAD include smoking cessation, exercise, treatment with statins, antiplatelet therapy with aspirin and clopidogrel, possibly cilostazol in patients without heart failure. Surgery is recommended for patients who do not respond to drug therapy.
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Siscovick, David, Frits Rosendaal, and Alexander Reiner. "Hemostatic Risk Factors and Arterial Thrombotic Disease." Thrombosis and Haemostasis 85, no. 04 (2001): 584–95. http://dx.doi.org/10.1055/s-0037-1615638.
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SummaryThe pathogenesis of arterial thrombotic disease involves multiple genetic and environmental factors related to atherosclerosis and thrombosis. Acute thrombosis at the site of a ruptured, lipid-rich atherosclerotic plaque is the usual precipitating event in the transition from stable or subclinical atherosclerotic disease to acute myocardial infarction (MI), stroke, or peripheral arterial occlusion (1). Pathologic studies of coronary arteries in acute MI suggest that the acute thrombosis likely involves activation of both platelets and the coagulation system.
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Genkel, V. V., A. S. Kuznetsova, E. V. Lebedev, and I. I. Shaposhnik. "Prognostic significance of atherosclerosis of one or two vascular systems in patients with high and very high cardiovascular risk." Cardiovascular Therapy and Prevention 20, no. 2 (March 28, 2021): 2669. http://dx.doi.org/10.15829/1728-8800-2021-2669.
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Aim. To study the prognostic significance of atherosclerosis of one and several vascular systems in patients with high and very high cardiovascular risk (CVR).Material and methods. The study included 171 patients with high (26,9%) and very high (73,1%) CVR. All patients underwent duplex ultrasound of the carotid and lower limb arteries. The composite endpoint (CE) was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and coronary revascularization.Results. The follow-up period lasted 31,1 (17,8; 47,9) months. CE events occurred in 29 (16,9%) patients: cardiovascular death — 3 (1,75%) patients; nonfatal myocardial infarction — 7 (4,09%) patients; nonfatal stroke — 6 (3,51%) patients; coronary revascularization — 13 (7,60%) patients. Cumulative survival of patients with high and very high CVR with atherosclerotic plaques in the same vascular system did not significantly differ from that in patients with intact peripheral arteries (p=0,977). The event-free survival of patients with combined lesions of the carotid and lower limb arteries was significantly lower in comparison with patients with one vascular system involvement (p=0,011). The combined lesion of the carotid and lower limb arteries was associated with an increase in the relative risk (RR) of adverse cardiovascular events (RR, 3,15 (95% CI, 1,02-9,74; p=0,046), adjusted for sex, age, and peripheral arterial disease symptoms.Conclusion. In patients with high and very high CVR, atherosclerotic lesion of two vascular systems of peripheral arteries is associated with an increase in the RR of adverse cardiovascular events, adjusted for sex, age, and peripheral arterial disease symptoms. The presence of atherosclerotic plaques in one vascular bed was not associated with an increase in the risk of CE events.
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Massalha, Goyen, and Rudofsky. "Ein Stenosejet kann eine Dissektion der A. femoralis superficialis verursachen." Vasa 28, no. 2 (May 1, 1999): 131–33. http://dx.doi.org/10.1024/0301-1526.28.2.131.
Full textAbstract:
A dissection of the superficial femoral artery mainly occurs due to trauma or manipulation of the artery by means of interventional procedures. In contrast to dissections of the carotid arteries which are known to occur spontaneously we present the case of a stenosis of the superficial femoral artery that led to a dissection caused by the stenosis-jet. The dissection on the other hand caused an appositional thrombus which led to the embolic occlusion of the pedal-arteries. In case of peripheral embolisms in patients with or without history of peripheral arterial occlusion disease it is important to look for a causing arterial pathology preferably by duplex sonography.
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Vila, Elisabet, and Mercedes Salaices. "Cytokines and vascular reactivity in resistance arteries." American Journal of Physiology-Heart and Circulatory Physiology 288, no. 3 (March 2005): H1016—H1021. http://dx.doi.org/10.1152/ajpheart.00779.2004.
Full textAbstract:
Cytokine levels are elevated in many cardiovascular diseases and seem to be implicated in the associated disturbances in vascular reactivity reported in these diseases. Arterial blood pressure is maintained within a normal range by changes in peripheral resistance and cardiac output. Peripheral resistance is mainly determined by small resistance arteries and arterioles. This review focuses on the effects of cytokines, mainly TNF-α, IL-1β, and IL-6, on the reactivity of resistance arteries. The vascular effects of cytokines depend on the balance between the vasoactive mediators released under their influence in the different vascular beds. Cytokines may induce a vasodilatation and hyporesponsiveness to vasoconstrictors that may be relevant to the pathogenesis of septic shock. Cytokines may also induce vasoconstriction or increase the response to vasoconstrictor agents and impair endothelium-dependent vasodilatation. These effects may help predispose to vessel spasm, thrombosis, and atherogenesis and reinforce the link between inflammation and vascular disease.