scholarly journals Bicycle exercise ankle-brachial index recovery time as a novel metric for evaluating the hemodynamic significance of external iliac endofibrosis in competitive cyclists

Author(s):  
Kenneth Tran ◽  
Shernaz S. Dossabhoy ◽  
Sabina Sorondo ◽  
Jason T. Lee
VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Takashi Ohta ◽  
Sugimoto ◽  
Takeuchi ◽  
Hosaka ◽  
Ishibashi

Background: The selection of candidates for exercise training among patients with intermittent claudication is still a matter of debate. Patients and methods: Forty-nine patients with intermittent claudication due to arteriosclerosis obliterans were tested. Forty-six patients were men and 3 were women, with an average age of 65 years (range, 46 to 76 years). The patients walked on a treadmill at 2.4 km/h on a 12% upgrade followed by an appropriate period of rest for 30 minutes twice a day during a 3-week hospitalization. Programs were individualized for each patient. Four parameters were assessed after exercise training: (1) Ankle-brachial index (ABI) at rest, (2) Fall in ABI after 40 m of treadmill walking (ABI Fall 40), (3) the recovery time (RT 40) required for the ABI to return to resting levels after 40 m of walking, and (4) the maximal walking distance (MWD) on the treadmill. Results: The average ABI at rest before the 3-week training period was 0.60 ± 0.02 (mean ± SE), and after training it was 0.62 ± 0.02. There was a small although not statistically significant increase in the ABI after training. This increase in the ABI did not exceed 0.21. The average ABI Fall 40 before training was 0.36 ± 0.01, and after training it was 0.30 ± 0.02. The average RT 40 before training was 9.9 ± 0.8 min, and after training it was 6.2 ± 0.6 min. There were significant decreases in the ABI Fall 40 and RT 40 after training (p < 0.01 and p < 0.001, respectively). The MWD increased after training in 48 of the 49 patients. The average MWD increased from 134 ± 13 m to 226 ± 32 m after training (p < 0.001). The occlusion levels did not influence the results as training effects and hemodynamic parameters. Fourteen of 49 patients desired arterial reconstruction after exercise training. Conclusions: Patients with shorter RT 40’s before training achieved greater increases in the MWD after training. In patients with an RT 40 under 12 min, exercise training is indicated. However, there is some discrepancy between the increase in MWD and the degree of satisfaction in individual patients.


1999 ◽  
Vol 31 (Supplement) ◽  
pp. S277
Author(s):  
H. Higuchi ◽  
T. Katsumura ◽  
T. Hamaoka ◽  
T. Sako ◽  
K. Esaki ◽  
...  

2018 ◽  
Vol 75 (8) ◽  
pp. 478-488
Author(s):  
Kerstin A. Schürch ◽  
Sebastian Sixt ◽  
Christina Jeanneret ◽  
Corina R. Canova

Zusammenfassung. Die Prävalenz der peripheren arteriellen Verschlusskrankheit (pAVK) steigt mit zunehmendem Alter an und nimmt aufgrund der demographischen Entwicklung insgesamt zu. Die Symptome schränken die Lebensqualität ein. Die 5-Jahresmortalität der pAVK-Patienten ist doppelt so hoch wie bei Patienten ohne pAVK und liegt höher als diejenige von Patienten mit einer isolierten koronaren oder zerebrovaskulären Verschlusskrankheit. Die Diagnosestellung ist bereits klinisch (Pulspalpation) oder mit einfachen apparatetechnischen Mitteln (Knöchel-Arm-Index = Ankle-Brachial-Index (ABI)) durch jeden Arzt zur Diagnosestellung – nicht zum Ausschluss – möglich. Fachärztliche Zusatzuntersuchungen sollen stufenweise eingesetzt werden. Die Behandlung der PAVK ist stadienabhängig. Wichtigster Therapiepfeiler in allen Stadien der pAVK ist die Behandlung der kardiovaskulären Risikofaktoren mit strengen Ziel-Blutdruck und Zielcholesterinwerten für diese Hochrisikopatienten. Zusätzlich stehen Antiaggregations- und Antikoagulationsmöglichkeiten zur Diskussion. Als aktive Massnahmen wie das konservative Gehtraining sind heute kathetertechnische Verfahren häufig Therapie der ersten Wahl. Zudem steigt auch die Zahl kombinierter chirurgisch-kathetertechnischer Verfahren, sog. Hybrideingriffe. Gute Indikationen für chirurgische Verfahren stellen weiterhin langstreckige femorale bis popliteale Verschlüsse bei operablen jüngeren Patienten und Verschlussprozesse in der Femoralbifurkation dar. Die invasive Therapiewahl soll interdisziplinär getroffen werden.


VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.


VASA ◽  
2019 ◽  
Vol 48 (5) ◽  
pp. 413-417 ◽  
Author(s):  
Serge Couzan ◽  
Jean-François Pouget ◽  
Claire Le Hello ◽  
Céline Chapelle ◽  
Silvy Laporte ◽  
...  

Summary. Background: Theoretically progressive compression stockings, which produce a higher compression at the calf than at the ankle level, improve venous return flow without exacerbating peripheral arterial insufficiency (PAD). We aimed to evaluate the short-term tolerance of elastic progressive compression stockings on peripheral arterial vascularisation in patients with symptomatic PAD and associated mild venous insufficiency. Patients and methods: Monocentric, prospective, open pilot study of 18 patients (acceptability study, 6 x 6 plan) evaluating the short-term tolerance of progressive compression stockings (18 ± 2 mmHg at calf and 8 ± 2 mmHg at ankle level) in patients with PAD (ankle brachial index ABI > 0.60 < 0.75) and chronic venous insufficiency (C1s–C4 stages of the CEAP classification). Day 15 tolerance was evaluated by a composite primary criteria comprising: no decrease > 15 % of ABI on each side, no decrease > 15 % of toe brachial index (TBI) on each side and no decrease > 25 % of the number of active plantar flexions performed while standing. Results: The proportion of men was 77.8 %, mean age was 77.3 ± 7.5 years and no patient were diabetic. At inclusion, the mean low ABI was 0.60 ± 0.04 and the mean high ABI was 0.77 ± 0.18. The mean low TBI was 0.32 ± 0.09 and the mean high TBI 0.46 ± 0.15. The mean number of active standing plantar flexions was 33.0 ± 5.0. The majority of the patients were classified in CEAP C2s and C3 classes (class 2: 16.7 %, class C2s: 27.8 %, class C3: 44.4 %, class C4: 5.6 % and class C4s: 5.6 %). Poor tolerance occurred in no patient. By day 30, no patient had worsening of their arterial and venous symptoms. No adverse events occurred during the study. Conclusions: These results suggest a high tolerance of progressive elastic stockings (18 ± 2 mmHg at calf and 8 ± 2 mmHg at ankle level) in symptomatic PAD.


VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 159-160
Author(s):  
Espinola-Klein ◽  
F. Dopheide ◽  
Gori

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 284-291 ◽  
Author(s):  
Seong-Woo Choi ◽  
Hye-Yeon Kim ◽  
Hye-Ran Ahn ◽  
Young-Hoon Lee ◽  
Sun-Seog Kweon ◽  
...  

Background: To investigate the association between ankle-brachial index (ABI), left ventricular hypertrophy (LVH) and left ventricular mass index (LVMI) in a general population. Patients and methods: The study population consisted of 8,246 people aged 50 years and older who participated in the baseline survey of the Dong-gu Study conducted in Korea between 2007 and 2010. Trained research technicians measured LV mass using mode M ultrasound echocardiography and ABI using an oscillometric method. Results: After adjustment for risk factors and common carotid artery intima-media thickness (CCA-IMT) and the number of plaques, higher ABIs (1.10 1.19, 1.20 - 1.29, and ≥ 1.30) were significantly and linearly associated with high LVMI (1.10 - 1.19 ABI: β, 3.33; 95 % CI, 1.72 - 4.93; 1.20 - 1.29 ABI: β, 6.51; 95 % CI, 4.02 - 9.00; ≥ 1.30 ABI: β, 14.83; 95 % CI, 6.18 - 23.48). An ABI of 1.10 - 1.19 and 1.20 - 1.29 ABI was significantly associated with LVH (1.10 - 1.19 ABI: OR, 1.35; 95 % CI, 1.19 - 1.53; 1.20 - 1.29 ABI: OR, 1.59; 95 % CI, 1.31 - 1.92) and ABI ≥ 1.30 was marginally associated with LVH (OR, 1.73; 95 % CI, 0.93 - 3.22, p = 0.078). Conclusions: After adjustment for other cardiovascular variables and CCA-IMT and the number of plaques, higher ABIs are associated with LVH and LVMI in Koreans aged 50 years and older.


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