Pharmacologic Risk Factor Treatment of Peripheral Arterial Disease is Lacking and Requires Vascular Surgeon Participation

2007 ◽  
Vol 21 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Christian Bianchi ◽  
Valerie Montalvo ◽  
Harry W. Ou ◽  
Vicki Bishop ◽  
Ahmed M. Abou-Zamzam
Keyword(s):  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Vascular Surgeon ◽  
Peripheral Arterial

Secondary medical prevention in patients with peripheral arterial disease - Prescriptions of vascular surgeons and medical doctors (angiologists) in a multidisciplinary vascular centre

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Klein-Weigel ◽  
Gutsche-Petrak ◽  
Wolbergs ◽  
Köning ◽  
Flessenkamper
Keyword(s):  
Peripheral Arterial Disease ◽  
Oral Anticoagulants ◽  
Arterial Disease ◽  
Disease Stage ◽  
Channel Blockers ◽  
Medical Doctors ◽  
Vascular Surgeon ◽  
Medical Prevention ◽  
Number Of Patients ◽  
Peripheral Arterial

Background: We compared medical secondary prevention in patients with peripheral arterial disease stage II (Fontaine) located in the femoro-popliteal artery managed by vascular surgeons and medical doctors / angiologists in our multidisciplinary vascular center. Patients and methods: We retrospectively analyzed demission protocols of in-hospital treatments between 01.01.2007 and 20.06.2008. Results: We surveyed 264 patients (54.2 % women; mean age 67.52 ± 8.98 yrs), 179 (67.8 %) primarily treated by medical doctors / angiologists and 85 (32.2 %) primarily managed by vascular surgeons. Medical doctors / angiologists treated more women (n = 109) than men (n = 34), (p = 0.002) and documented smoking and diabetes mellitus more often (p < 0.001) than vascular surgeons. Besides, patients had similar cardiovascular risk profiles and concomitant diseases, vascular surgeons prescribed 5.47 ± 2.26 drugs, medical doctors / angiologists 6.37 ± 2.67 (p = 0.005). Overall, 239 (90.5 %) patients were on aspirin, 180 (68.2 %) on clopidogrel, and 18 (6.9 %) on oral anticoagulants. Significantly more patients treated by medical doctors / angiologists received clopidogrel (169 versus 11; p < 0.001), significantly more surgical patients received oral anticoagulants (11 versus 7; p = 0.016). The number of patients without prescriptions for any antithrombotic therapy was 6 (6.9 %) in patients treated by vascular surgeons and 0 (0 %) in patients managed by medical doctors / angiologists (p = 0.001). Prescription-rates of β-blockers, ACE-inhibitors, Angiotensin II-antangonists, calcium channel blockers, and diuretics were statistically not different between the two disciplines, but statins were prescribed significantly more often by medical doctors / angiologists (139 versus 49; p < 0001). With the exceptions of Clopidogrel (women > men) and diuretics (men > women) we observed no gender-specific prescriptions. Conclusions: We observed high prescriptions rates of secondary medical prevention in patients primarily treated by medical doctors / angiologists and vascular surgeons. We believe that this result is highly influenced by our multidisciplinary approach. Nevertheless, efforts have to be made to raise vascular surgeon’s awareness of statin use and complete prescription of antithrombotic and antiplatelet drugs.

Lipoprotein(a) as a unique primary risk factor for early atherosclerotic peripheral arterial disease

2021 ◽  
Vol 14 (6) ◽  
pp. e243231
Author(s):  
John Mayo ◽  
Thomas Hoffman ◽  
Ryan Smith ◽  
Dwight Kellicut
Keyword(s):  
Risk Factor ◽  
Cardiovascular Diseases ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Common Condition ◽  
Elevated Plasma ◽  
Early Screening ◽  
Lipoprotein A ◽  
Peripheral Arterial ◽  
Primary Risk Factor

Elevated plasma lipoprotein(a) is a relatively common condition that contributes to many cardiovascular diseases. However, the awareness and testing for this condition remain low. Herein, we present a case of an otherwise healthy and active man who developed symptoms of peripheral arterial disease starting at age 49, and was found to have hyper-lipoprotein(a) as his only notable risk factor. Diagnosis was not made until years later, after an extensive workup. Upon further screening, he was also found to have subclinical coronary and carotid artery atherosclerotic disease. The patient was treated with aspirin, statin, niacin and angioplasty to bilateral superficial femoral arteries with good symptom resolution. Early screening of his son also revealed a similarly elevated lipoprotein(a) level. It is important to raise awareness of this condition and its relationship to early-onset peripheral arterial disease so patients and their families can be appropriately identified, counselled and treated.

Dynamic thiol/disulphide homeostasis metrics as a risk factor for peripheral arterial disease

Vascular ◽  
2020 ◽  
pp. 170853812094724
Author(s):  
Ufuk Turan Kursat Korkmaz ◽  
Ahmet Yuksel ◽  
Ayhan Cetinkaya ◽  
Yusuf Velioglu ◽  
Erhan Renan Ucaroglu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Laboratory Data ◽  
Arterial Disease ◽  
Control Group ◽  
Study Group ◽  
Total Thiol ◽  
Peripheral Arterial ◽  
Study Participants

Objective To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease. Methods One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case–control study. Participants’ baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups. Results Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group ( p = 0.045, p = 0.000 and p = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group ( p = 0.000, p = 0.000 and p = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease. Conclusion Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.

Gene Therapy for Chronic Peripheral Arterial Disease: What Role for the Vascular Surgeon?

2004 ◽  
Vol 18 (6) ◽  
pp. 758-765 ◽  
Author(s):  
Laurent Barandon ◽  
Lionel Leroux ◽  
Pascale Dufourcq ◽  
Philippe Plagnol ◽  
Claude Deville ◽  
...  
Keyword(s):  
Gene Therapy ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Vascular Surgeon ◽  
Peripheral Arterial

scholarly journals Role and Management of Coagulation Disorders in Peripheral Arterial Disease

2012 ◽  
Vol 101 (2) ◽  
pp. 94-99 ◽  
Author(s):  
R. Lassila
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Management Strategies ◽  
Antiplatelet Agents ◽  
Arterial Disease ◽  
Medical Attention ◽  
Stable Form ◽  
Vascular Surgeon ◽  
Atherothrombotic Disease ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) has often underlying risk factors, of which diabetes and cigarette smoking are the most common. Enhanced platelet activation and interaction with vessel wall associate with atherothrombotic disease, but also increased fibrinogen levels, thrombin generation and fibrin turnover are typical for PAD. The pathogenic role of fibrinogen, thrombin formation and fibrin degradation is suggested not only in acute thrombotic complications, but also in the stable form of PAD, where these markers associate with the functional severity (ankle-brachial blood pressure index). The coagulation-specific etiologies of PAD should be suspected if the atherothrombotic disease has severe manifestations, especially while the traditional risk factors are absent, or if the patient has also a history of venous thromboembolism. Malignant disease may be present in form of peripheral arterial thrombosis as well. Thrombophilia may expose patients to idiopathic thrombosis – both spontaneously and after vascular interventions. The management of these patients includes often combination therapies with antiplatelet agents and anticoagulants. Obviously, the strict policy to avoid risk factors and to treat them well in avoidance of progression of arterial disease is highly important. In the absence of published follow-up data the evidence to support the management strategies is weak and individual tailoring of efficacious and safe antithrombotic drug therapy remains our challenge. These patients benefit from continuous medical attention by the experts in the field of angiology. Management of PAD is an excellent example of the multidisciplinary approach where the hematologist meets the vascular surgeon or interventional radiologist to secure the best available patient care.

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