scholarly journals Peripheral vascular disease assessment in the lower limb: a review of current and emerging non-invasive diagnostic methods

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Elham Shabani Varaki ◽  
Gaetano D. Gargiulo ◽  
Stefania Penkala ◽  
Paul P. Breen
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Diagnostic Methods ◽  
Disease Assessment ◽  
Peripheral Vascular ◽  
Non Invasive

scholarly journals O42: THE ROLE OF TOURNIQUETS IN TRANSTIBIAL AMPUTATION FOR PERIPHERAL VASCULAR DISEASE: A SYSTEMATIC REVIEW & META-ANALYSIS

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
D Cagney ◽  
J Byrne ◽  
GJ Fulton ◽  
BJ Manning ◽  
HP Redmond
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Revision Surgery ◽  
Lower Limb ◽  
Cochrane Library ◽  
Peripheral Vascular ◽  
Operative Blood Loss ◽  
Transfusion Requirements

Abstract Introduction The use of lower limb tourniquets is traditionally discouraged in severe atherosclerotic disease. However, blood loss and increased transfusion requirements are associated with post-operative morbidity in patients undergoing major lower limb amputation. The aim of this systematic review is to summarise and pool the available data to determine the impact of tourniquet application when performing trans-tibial amputation for peripheral vascular disease. Method This systematic review was conducted according to PRISMA guidelines. A systematic search of Medline, Embase and Cochrane Library was undertaken for articles which compared the use of a tourniquet versus no tourniquet in patients undergoing trans-tibial amputation for peripheral vascular disease. The main outcomes included intra-operative blood loss, post-operative transfusion requirement, need for revision surgery and 30-day mortality. Result Four studies met the inclusion criteria for quantitative analysis with a total of 267 patients. A tourniquet was used in 130 patients. Both groups were matched for age, gender, co-morbidities and pre-operative haemoglobin. In patients undergoing trans-tibial amputation, tourniquets were associated with significantly lower intra-operative blood loss (Mean difference= -147.6mls; P=0.03) and lower transfusion requirements (pooled odds ratio (OR), 0.12, p=0.03). The need for stump revision (OR, 0.7; p=0.48), proceeding to transfemoral amputation within 30 days (OR, 0.67; p=0.25) and 30-day mortality (OR, 0.65; p=0.41) all favoured tourniquet use but the differences were not found to be significant. Conclusion Tourniquets can reduce intra-operative blood loss and transfusion requirements in patients undergoing trans-tibial amputation without increasing ischaemic complications and need for revision surgery. Take-home message Tourniquets are safe to use in trans-tibial amputation for severe peripheral vascular disease and can reduce intra-operative blood loss without increasing ischaemic complications.

scholarly journals Prevalence of Peripheral Vascular Disease in Diabetic Foot Infections and its Effect on Management Outcome

2019 ◽  
Vol 38 (1) ◽  
pp. 12-17
Author(s):  
Farah Nobi ◽  
Syed Al Nahian ◽  
Afrin Sultana ◽  
Rokhsana Sarmin ◽  
Ayesha Rahman ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Peripheral Vascular ◽  
Tertiary Care Centre ◽  
Term Care ◽  
Diabetic Foot Infection ◽  
Diabetic Foot Infections

Background: Foot infection is a common problem affecting diabetics. Ischemia is a major factor contributing to progress and morbidity of the disease. The prevalence of peripheral vascular disease is higher in diabetics with faster progression. Aim: This study aimed to observe the prevalence of peripheral vascular disease in patients with diabetic foot infections presenting to this tertiary care centre. Methods: This prospective observational study evaluated 250 patients with diabetic foot infection admitted to Ibrahim Medical College and BIRDEM General Hospital, Dhaka, from 1st January 2015 to 31st December 2015.Total 72 patients were selected for Duplex study of lower limb vessels, Ankle Brachial Pressure Index (ABPI) and Pulse oxymetrywhich established the diagnosis of peripheral vascular disease and all patients were treated according to the standard protocol. Results: Of the 72 patients peripheral vascular disease was found in 25 patients (34.7%) and majority of them (88%) had distal below the knee vessel stenosis. There was significant correlation with older age (75%) and history of tobacco use (64%). The clinical presentations and outcomes such as hospital stay, healing time, pain were worse in individuals with peripheral vascular compromise on Duplex study of lower limb vessels, ABPI and pulse oxymetry. Conclusion: In this study we observed that significant number of diabetics presenting with foot infections have underlying peripheral vascular disease .The patients might not all be symptomatic or show obvious signs of PVD but need to be investigated for the same. Early detection of peripheral vascular disease in patients presenting with diabetic foot infection, using Duplex study,ABPI and Pulse oxymetrywith routine clinical and laboratory assessment can be of great value in long term care of these individuals. J Bangladesh Coll Phys Surg 2020; 38(1): 12-17

scholarly journals CHRONIC LIMB ISCHEMIA

2018 ◽  
Vol 25 (02) ◽  
pp. 201-204
Author(s):  
Fawad Farooq ◽  
Shams Uddin Shaikh ◽  
Shahbaz Shaikh ◽  
Tariq Ashraf
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Ankle Brachial Index ◽  
Limb Ischemia ◽  
Peripheral Vascular ◽  
Vascular Intervention ◽  
Study Results ◽  
Significant Difference ◽  
Chronic Limb Ischemia

Background: The Ankle brachial index (ABI) measurements are commonlyused inscreening and management of Peripheral Vascular Disease. In recent studies, Anklebrachial index (ABI) is utilized as a predictor of future atherosclerotic vascular disease andall-cause mortality. Purpose: The purpose of this study was to investigate utility of pre andpost peripheral vascular intervention ankle-brachial index (ABI) assessmentinpatientswith thechronic limb ischemia. Study Design: Quasi experimental study. Setting: National Instituteof Cardio-Vascular Disease (NICVD), Karachi, Pakistan. Period: January 2013 to June 2014.Methodology: The study included 23 patients hospitalized. According to study inclusion/exclusion criteria, patients of chronic limb ischemia on clinical ground and the vascular lesionsof lower limb according toTrans-Atlantic Inter-Society Consensus (TASC scoreclassification II)were evaluated and recruited. The lesions were further classified into three types, Aortoilliac,Femoropopliteal andTibioperoneal. Ankle brachial index (ABI) was classified according toAmerican Diabetic Association. The study was approved by the ethical committee of NICVD.Data was analyzed using SPSS 20. Inc. Results: The mean age of the enrolled patients was57.86±6.56 years. Majority of the patients were male 18(78.3%). The commonly found peripherallesion was femoropopliteal in 9(39%), TASC grade A was commonwith 8 (62%) of cases. ABIscore done pre and post procedure showed a significant difference with a (p-value<0.05) andthere was an improvement of ABI scores in all the lesions after peripheral vascular intervention.Conclusion: The study results concluded that there was animprovement in ABI score afterintervention of peripheral vascular surgery for lower limb segment and recommended its utilityfor the assessment in Peripheral Vascular Disease intervention.

Abstract 509: Screening for Carotid Occlusive Disease in Patients With Mild Peripheral Vascular Disease

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Andrew Harrington ◽  
Nicole Ilonzo ◽  
Thais Polanco ◽  
Kevin Yang ◽  
Selena Goss ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Occlusive Disease ◽  
Receiver Operating Curve ◽  
Peripheral Vascular ◽  
Non Invasive ◽  
Carotid Duplex ◽  
Carotid Occlusive Disease ◽  
Clinically Significant

Objectives: Peripheral vascular disease (PVD) is a systemic disorder, which can affect all territories of arteries. In order to maximize screening survey yield: we aimed to describe the association between positive lower extremity (LE) non-invasive flow studies in symptomatic patients and occult carotid occlusive disease (COD). Methods: A retrospective chart review was performed on 420 patients who underwent carotid duplex ultrasound and non-invasive flow studies (NIFS; aka Pulse volume recordings) for evaluation of COD and LE PVD respectively. Additional clinical variables collected included age, gender, and indication for NIFS and indication for carotid duplex. The respective studies were performed within a year of each other. Statistical analysis was performed using SPSSv20 software and SAS statistical software. Univariate analysis was performed using Mann-Whitney, student t-test and receiver operating curve (ROC). Results: 66% (266/420) of the patients were male and 43% (181/420) of patients had documented history of bruit. Patients with mild PVD (ABI between 0.81 and 1) were more likely to have clinically significant COD than patients with moderate to severe PVD (ABI < 0.8) (25% vs 16.19%, P=0.03). Therefore, severity of peripheral vascular disease did not correlate with likelihood of clinically significant COD (p>0.05). ROC analysis was performed (AUC=0.602, p=0.05). Low ABI 0.50 was found to be 92% sensitive (Se) but only 14% specific (Sp). The optimal ABI cutoff point for predicting COD was 0.95 (Se=40%,Sp 60%, Youden’s index 0.194) Conclusion: Therefore, routine screening for COD in patients with lower extremity peripheral vascular disease is unlikely to uncover clinically significant carotid stenosis. These findings do not indicate a population of patients for which a combined prospective screening is warranted.

Sign in / Sign up

Export Citation Format

Share Document