Medical Management of Lower Extremity Peripheral Artery Disease

2017 ◽  
pp. 1-8 ◽  
Author(s):  
Akshar Y. Patel ◽  
Hitinder S. Gurm
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Medical Management ◽  
Peripheral Artery ◽  
Artery Disease

Medical Management of Lower Extremity Manifestations of Peripheral Artery Disease

2015 ◽  
Author(s):  
Mary M. McDermott
Keyword(s):  
United States ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Medical Management ◽  
Cardiovascular Events ◽  
The United States ◽  
Peripheral Artery ◽  
Exercise Interventions ◽  
Medical Therapies ◽  
Artery Disease

Lower extremity peripheral artery disease (PAD) affects eight million people in the United States and over 200 million men and women worldwide. Furthermore, recent evidence from the Global Disease Burden suggests that the prevalence of PAD increased worldwide by 20% between 2000 and 2010. Patients with PAD are at increased risk for cardiovascular events, functional impairment, and mobility loss. With advancements in medical science and improved treatments for cardiovascular disease, rates of cardiovascular events have declined in the United States and in other high socioeconomic countries. Consequently, people are living longer with chronic debilitating diseases, such as PAD. Optimal medical management of patients with PAD is essential to help these patients survive longer with optimal quality of life and without disability. This review covers medical therapies to improve lower extremity functioning in people with PAD, additional medications to improve walking performance in PAD, and both walking and nonwalking exercise interventions for lower extremity PAD,  Tables outline outcome measures typically used to assess improvement in response to medical therapies for PAD; FDA-approved medications and medications that may be beneficial but are not FDA-approved for intermittent claudication symptoms; exercise therapies that benefit patients with PAD; and additional considerations regarding exercise therapy in PAD. Graphs showcase ramipril versus placebo and changes in walking time according to home-based versus supervised walking exercise. This review contains 2 figures, 5 tables, and 68 references.

Medical Management of Lower Extremity Manifestations of Peripheral Artery Disease

2015 ◽  
Author(s):  
Mary M. McDermott
Keyword(s):  
United States ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Medical Management ◽  
Cardiovascular Events ◽  
The United States ◽  
Peripheral Artery ◽  
Exercise Interventions ◽  
Medical Therapies ◽  
Artery Disease

Lower extremity peripheral artery disease (PAD) affects eight million people in the United States and over 200 million men and women worldwide. Furthermore, recent evidence from the Global Disease Burden suggests that the prevalence of PAD increased worldwide by 20% between 2000 and 2010. Patients with PAD are at increased risk for cardiovascular events, functional impairment, and mobility loss. With advancements in medical science and improved treatments for cardiovascular disease, rates of cardiovascular events have declined in the United States and in other high socioeconomic countries. Consequently, people are living longer with chronic debilitating diseases, such as PAD. Optimal medical management of patients with PAD is essential to help these patients survive longer with optimal quality of life and without disability. This review covers medical therapies to improve lower extremity functioning in people with PAD, additional medications to improve walking performance in PAD, and both walking and nonwalking exercise interventions for lower extremity PAD,  Tables outline outcome measures typically used to assess improvement in response to medical therapies for PAD; FDA-approved medications and medications that may be beneficial but are not FDA-approved for intermittent claudication symptoms; exercise therapies that benefit patients with PAD; and additional considerations regarding exercise therapy in PAD. Graphs showcase ramipril versus placebo and changes in walking time according to home-based versus supervised walking exercise. This review contains 2 figures, 5 tables, and 68 references.

Relationship of triglyceride–glucose index with chronic limb-threatening ischemia in lower extremity peripheral artery disease

Vascular ◽  
2021 ◽  
pp. 170853812110183
Author(s):  
Arda Aybars Pala ◽  
Yusuf Salim Urcun
Keyword(s):  
Lower Extremity ◽  
High Density Lipoprotein ◽  
Peripheral Artery Disease ◽  
Density Lipoprotein ◽  
Peripheral Artery ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Objectives Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development. Methods A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as “Group 1” ( n = 224) and those who developed were classified as “Group 2” ( n = 72). Results The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, p < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092–1.363, p < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715–0.839, p < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050–16.382, p = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, p < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume. Conclusions Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.

PMD21 The Association of Major Adverse LIMB Events and Combination Stent and Atherectomy in Patients Undergoing Revascularization for Lower Extremity Peripheral Artery Disease

2021 ◽  
Vol 24 ◽  
pp. S127
Author(s):  
L. Gressler ◽  
D. Marinac-Dabic ◽  
S. Dosreis ◽  
P. Goodney ◽  
C.D. Mullins ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease

scholarly journals Guideline-Oriented Therapy of Lower Extremity Peripheral Artery Disease (PAD) – Current Data and Perspectives

2019 ◽  
Vol 191 (04) ◽  
pp. 311-322 ◽  
Author(s):  
Jonas Kersting ◽  
Lars Kamper ◽  
Marco Das ◽  
Patrick Haage
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Bypass Surgery ◽  
Interdisciplinary Approach ◽  
Current Data ◽  
Arterial System ◽  
Peripheral Artery ◽  
Vascular Surgeon ◽  
Technical Developments ◽  
Artery Disease

Background Because of the demographic change, lower extremity peripheral artery disease (PAD) is becoming increasingly relevant with respect to health economics. PAD patients often suffer from multiple diseases. Consequently, therapy is commonly complex and requires an interdisciplinary approach. Because of rapid technical developments, interventional endovascular therapy regimens play an increasingly important role. Method Review and literature search on the basis of the current German S3 guidelines on the therapy of PAD as well as international guidelines. In terms of state-of-the-art therapies, relevant current studies were considered. Results Knowledge of existing guidelines and recommendations as well as new therapeutic approaches is essential for the adequate therapy of PAD patients. A close cooperation between the interventional radiologist and the vascular surgeon is the key to success. In addition to established conservative approaches and invasive bypass surgery, the endovascular approach has been a mainstay in the TASC A and B environment for years. It has recently shown promising results in advanced PAD conditions, such as TASC C and D. An endovascular-first strategy is defined in most guidelines. Conclusion A primarily endovascular-first strategy has become the standard in the majority of even complex lesions of the lower extremity arterial system. Regarding the crural segment, a decrease in mortality compared to bypass surgery has been demonstrated. Further evidence can be expected from ongoing randomized multicenter trials. Key Points:  Citation Format

scholarly journals PLACE AND VALUE OF ENDOVASCULAR AND HYBRID TECHNOLOGIES IN TREATMENT OF LOWER EXTREMITY PERIPHERAL ARTERY DISEASE

2018 ◽  
Vol 20 (1) ◽  
pp. 103-112
Author(s):  
Khotira Sukhrobdzhanovna Mukhammadieva ◽  
◽  
Alidjon Djuraevich Gaibov ◽  
Alisher Kenjaevich Baratov ◽  
Egan Leonidovich Kalmykov ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Hybrid Technologies ◽  
Artery Disease

scholarly journals Ticagrelor Compared With Clopidogrel in Patients With Prior Lower Extremity Revascularization for Peripheral Artery Disease

2017 ◽  
Vol 65 (4) ◽  
pp. 1239
Author(s):  
W.S. Jones ◽  
I. Baumgartner ◽  
W.R. Hiatt ◽  
G. Heizer ◽  
M.S. Conte ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Lower Extremity Revascularization
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