Study on Unrecognized Peripheral Arterial Disease (PAD) by Ankle/Brachial Index and Arterial Comorbidity in Catania, Sicily, Italy

Angiology ◽  
2010 ◽  
Vol 61 (6) ◽  
pp. 524-529 ◽  
Author(s):  
Salvatore Santo Signorelli ◽  
Massimiliano Anzaldi ◽  
Valerio Fiore ◽  
Stefano Catanzaro ◽  
Massimo Simili ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Peripheral Arterial

scholarly journals Hallucal thenar index: A new index to detect peripheral arterial disease using laser speckle flowgraphy

Vascular ◽  
2020 ◽  
pp. 170853812093893
Author(s):  
Kazuhiro Tsunekawa ◽  
Fumio Nagai ◽  
Tamon Kato ◽  
Ikkei Takashimizu ◽  
Daisuke Yanagisawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peripheral Arterial Disease ◽  
Operating Characteristic ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Laser Speckle ◽  
Laser Speckle Flowgraphy ◽  
Skin Perfusion ◽  
Peripheral Arterial ◽  
Cutaneous Blood

Objectives Laser speckle flowgraphy is a technology using reflected scattered light for visualization of blood distribution, which can be used to measure relative velocity of blood flow easily without contact with the skin within a short time. It was hypothesized that laser speckle flowgraphy may be able to identify foot ischemia. This study was performed to determine whether laser speckle flowgraphy could distinguish between subjects with and without peripheral arterial disease. Materials and methods All subjects were classified based on clinical observations using the Rutherford classification: non-peripheral arterial disease, class 0; peripheral arterial disease group, class 2–5. Rutherford class 6 was one of the exclusion criteria. Laser speckle flowgraphy measured the beat strength of skin perfusion as an indicator of average dynamic cutaneous blood flow change synchronized with the heartbeat. The beat strength of skin perfusion indicates the strength of the heartbeat on the skin, and the heartbeat strength calculator in laser speckle flowgraphy uses the blood flow data to perform a Fourier transform to convert the temporal changes in blood flow to a power spectrum. A total of 33 subjects with peripheral arterial disease and 40 subjects without peripheral arterial disease at a single center were prospectively examined. Laser speckle flowgraphy was used to measure hallucal and thenar cutaneous blood flow, and the measurements were repeated three times. The hallucal and thenar index was defined as the ratio of beat strength of skin perfusion value on hallux/beat strength of skin perfusion value on ipsilateral thenar eminence. The Mann–Whitney U-test was used to compare the median values of hallucal and thenar index and ankle brachial index between the two groups. A receiver operating characteristic curve for hallucal and thenar index of beat strength of skin perfusion was plotted, and a cutoff point was set. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index was explored in all subjects, the hemodialysis group, and the non-hemodialysis (non-hemodialysis) group. Results The median value of the hallucal and thenar index of beat strength of skin perfusion was significantly different between subjects with and without peripheral arterial disease (0.27 vs. 0.87, respectively; P <  0.001). The median value of ankle brachial index was significantly different between subjects with and without peripheral arterial disease (0.8 vs. 1.1, respectively; P <  0.001). Based on the receiver operating characteristic of hallucal and thenar index, the cutoff was 0.4416 and the sensitivity, specificity, positive predictive value, and negative predictive value were 68.7%, 95%, 91.7%, and 77.6%, respectively. The correlation coefficients of all subjects, the hemodialysis group, and the non-hemodialysis group were 0.486, 0.102, and 0.743, respectively. Conclusions Laser speckle flowgraphy is a noninvasive, rapid, and widely applicable method. Laser speckle flowgraphy using hallucal and thenar index would be helpful to determine the differences between subjects with and without peripheral arterial disease. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index indicated that this index was especially useful in the non-hemodialysis group.

Clinical examination of peripheral arterial disease and ankle–brachial index in a nationwide cohort of older subjects: practical implications

2018 ◽  
Vol 31 (10) ◽  
pp. 1443-1449 ◽  
Author(s):  
Jarosław Królczyk ◽  
Karolina Piotrowicz ◽  
Jerzy Chudek ◽  
Monika Puzianowska-Kuźnicka ◽  
Małgorzata Mossakowska ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Clinical Examination ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Older Subjects ◽  
Peripheral Arterial ◽  
Practical Implications

Peripheral Arterial Disease and the Ankle-Brachial Index

2009 ◽  
Vol 27 (3) ◽  
pp. 160-167 ◽  
Author(s):  
Elmira T. Asongwed ◽  
Steven B. Chesbro ◽  
Spiridon G. Karavatas
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Peripheral Arterial

Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients

2018 ◽  
Vol 38 (5) ◽  
pp. 366-373 ◽  
Author(s):  
Satu Mäkelä ◽  
Markku Asola ◽  
Henrik Hadimeri ◽  
James Heaf ◽  
Maija Heiro ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Aortic Calcification ◽  
Dialysis Patients ◽  
X Ray ◽  
Abdominal Aortic ◽  
All Cause Mortality ◽  
Peripheral Arterial

BackgroundPeripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.MethodsWe enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013. The abdominal aortic calcification score (AACS) was assessed using lateral lumbar X ray, and the ankle-brachial index (ABI) using a Doppler device.ResultsThe median AACS was 11 (range 0 – 24). In 58% of the patients, all 4 segments of the abdominal aorta showed deposits, while 19% of patients had no visible deposits (AACS 0). Ankle-brachial index was normal in 49%, low (< 0.9) in 17%, and high (> 1.3) in 34% of patients. Altogether 91 patients (37%) died during the median follow-up of 46 months. Only 2 patients (5%) with AACS 0 died compared with 50% of the patients with AACS ≥ 7 ( p < 0.001). The adjusted hazard ratio for all-cause mortality was 4.85 (95% confidence interval [CI] 1.94 – 24.46) for aortic calcification (AACS ≥ 7), 2.14 for diabetes (yes/no), 0.93 for albumin (per 1 g/L), and 1.04 for age (per year). A low or high ABI were not independently associated with mortality.ConclusionsSevere aortic calcification was a strong predictor of all-cause mortality in PD patients. The evaluation of aortic calcifications by lateral X ray is a simple method that allows the identification of high-risk patients.

Abstract 278: Lipid Control in Patients With New Symptoms of Peripheral Arterial Disease Evaluated at Vascular Specialty Clinics

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Kim Smolderen ◽  
Jan-Willem Elshof ◽  
Moniek van Zitteren ◽  
John A Spertus ◽  
Johan Denollet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Secondary Prevention ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Initial Evaluation ◽  
Specialty Clinic ◽  
Lipid Control ◽  
Peripheral Arterial

Background: Obtaining adequate lipid control (LDL-Cholesterol [LDL] <100 mg/dL) in patients with peripheral arterial disease (PAD) is a critical, guideline-directed secondary prevention target. Current compliance with this recommendation is unknown. Methods: A total of 616 patients had their LDL levels measured at 2 vascular specialty clinics in the Netherlands (March 2006-November 2011) during the evaluation of new PAD symptoms. A year following this evaluation, 417 (68%) patients had their LDL levels re-assessed. Information about patients’ demographic and clinical factors was systematically abstracted from medical records. Categories of patients were created based on the attainment of the recommended LDL target (<100 mg/dL [on target] vs. ≥100 mg/dL [off target]). Predictors of being off target at initial evaluation and at 1-year follow-up were identified through multivariable logistic regression analyses. Results: Of the total group, 57% (351/616) were off target at initial evaluation and 81% (496/616) were on lipid-lowering drugs after the initial evaluation at the PAD specialty clinic. One year later, only 25% (103/417) got on target, while 35% (147/417) patients remained off target, and an additional 10% (43/417) saw an increase in LDL to become off target. A total of 30% (124/417) remained on target. Patients with hypertension, diabetes, a history of myocardial infarction, and a lower ankle-brachial index were less likely to be off target at initial evaluation. Predictors of being off target at 1-year follow-up were male sex, and having a higher ankle-brachial index ( Table ). Conclusion: About half of patients with PAD seen at vascular specialty clinics had above-target LDL levels both upon entry and 1 year later. Patients with existing cardiovascular risk factors were much better controlled, as compared with patients without such risk factors. Males and those with higher ankle-brachial indices were less likely to be on target 1 year following management at the specialty clinic. Reasons for poorly regulated lipids need to be further explored, and appropriate quality-of-care improvement strategies will likely be needed to optimize secondary prevention.

Positive correlation of serum indoxyl sulfate level with peripheral arterial disease in hemodialysis patients

Vascular ◽  
2021 ◽  
pp. 170853812110399
Author(s):  
Liang-Te Chiu ◽  
Lin Lin ◽  
Huei-Jhen Lin ◽  
Yu-Hsien Lai ◽  
Bang-Gee Hsu
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Serum Levels ◽  
Arterial Disease ◽  
Indoxyl Sulfate ◽  
Maintenance Hemodialysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Index Group ◽  
Peripheral Arterial

Objectives Indoxyl sulfate, known for its cardiovascular toxicity, is associated with vascular and coronary artery diseases and increased mortality. Peripheral arterial disease, defined by low ankle–brachial index, is associated with increased mortality in patients on hemodialysis. The present study aimed to determine the relationship between the serum indoxyl sulfate level and peripheral arterial disease in patients on maintenance hemodialysis. Methods The present cross-sectional, single-center study included 75 patients on maintenance hemodialysis. Serum indoxyl sulfate levels were determined by high-performance liquid chromatography–mass spectrometry. Ankle–brachial index values were measured using an automated oscillometric device. Patients with ankle–brachial indexes of < 0.9 were categorized into the low ankle–brachial index group. Results In the study cohort, 12 of the 75 patients (16.0%) had low ankle–brachial indexes. The rates of diabetes mellitus ( p = 0.010) as well as the serum levels of C-reactive protein ( p < 0.001) and indoxyl sulfate ( p < 0.001) were higher in the low ankle–brachial index group than the normal ankle–brachial index group. The multivariable logistic regression analysis revealed that serum levels of indoxyl sulfate (odds ratio = 1.123, 95% confidence interval 1.011–1.249, p = 0.031) and C-reactive protein (each 0.1 mg/dL increase, odds ratio = 1.169, 95% confidence interval 1.018–1.343, p = 0.027) were independently associated with peripheral arterial disease in patients on maintenance hemodialysis. Conclusions Serum indoxyl sulfate levels were associated with peripheral arterial disease in patients on maintenance hemodialysis.

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