The Effeciveness of Exercise Prescription in Patients Treated for Peripheral Artery Disease of Lower Limbs

Abstract Background Colorectal cancer and peripheral artery disease are common conditions in older adults and may coexist in this population. Lymph node dissection along the inferior mesenteric artery is a vital procedure in cases of left-sided colorectal cancer. However, the inferior mesenteric artery may show a collateral blood pathway in rare cases of peripheral artery disease. We report a case of advanced sigmoid colon cancer in which the lower limbs received inferior mesenteric artery flow owing to asymptomatic peripheral artery disease. The possibility of catastrophic lower-limb ischemia because of complete mesenteric excision with ligation of the inferior mesenteric artery was a matter of concern in this case. Case presentation A 73-year-old man with asymptomatic peripheral artery disease was diagnosed with stage IIIB advanced sigmoid colon cancer. Angiography using a balloon-occlusion catheter revealed that his lower limbs received prominent inferior mesenteric artery blood flow through a collateral pathway. Therefore, interventional radiologists and cardiovascular surgeons evaluated the indications for endovascular stents or bypass grafts. The patient also had dilated cardiomyopathy, so the cardiovascular physicians evaluated his tolerance in the worst-case scenario of a colorectal anastomotic leak. The patient underwent axillofemoral artery bypass and two-stage laparoscopic sigmoid colectomy without anastomosis. The postoperative course was uneventful, and he resumed his job within a month after the resection. Conclusions Although collateral flow from the inferior mesenteric artery is rare in patients with peripheral artery disease, a few case reports have described fatal lower-limb ischemia following anterior resection. The perioperative multidisciplinary evaluation enabled us to understand the patient’s condition and risks, and allowed successful cancer treatment without ischemia of the lower limbs.

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International public awareness of peripheral artery disease

VASA ◽

10.1024/0301-1526/a000945 ◽

2021 ◽

pp. 1-7

Author(s):

Rupert Bauersachs ◽

Marianne Brodmann ◽

Christopher Clark ◽

Sebastian Debus ◽

Marco De Carlo ◽

...

Keyword(s):

Peripheral Artery Disease ◽

Public Awareness ◽

Age Groups ◽

Lower Limbs ◽

Common Condition ◽

Peripheral Artery ◽

Health And Disease ◽

Artery Disease ◽

Gender Based ◽

Delays In Diagnosis

Summary: Background: Peripheral artery disease (PAD) of the lower limbs is a common condition with considerable global burden. Some country-specific studies suggest low levels of public awareness. To our knowledge public awareness of PAD has never been assessed simultaneously in several countries worldwide. Patients and methods: This was an international, general public, internet-based quantitative survey assessing vascular health and disease understanding. Questionnaires included 23 closed-ended multiple-choice, Likert scale and binary choice questions. Data were collected from 9,098 survey respondents from nine countries in Europe, North and Latin America during May-June 2018. Results: Overall, familiarity with PAD was low (57% of respondents were “not at all familiar”, and 9% were “moderately” or “very familiar”). Knowledge about PAD health consequences was limited, with 55% of all respondents not being aware of limb consequences of PAD. There were disparities in PAD familiarity levels between countries; highest levels of self-reported awareness were in Germany and Poland where 13% reported to be “very” or “moderately” familiar with PAD, and lowest in Scandinavian countries (5%, 3% and 2% of respondents in Norway, Sweden and Denmark, respectively). There were disparities in awareness according to age. Respondents aged 25–34 were most familiar with PAD, with 12% stating that they were “moderately” or “very” familiar with the condition, whereas those aged 18–24 were the least familiar with PAD (7% “moderately” or “very” familiar with PAD). In the 45–54, 55–64 and 65+ age groups, 9% said they were “moderately” or “very” familiar with the term. There was no important gender-based difference in PAD familiarity. Conclusions: On an international level, public self-reported PAD awareness is low, even though PAD is a common condition with considerable burden. Campaigns to increase PAD awareness are needed to reduce delays in diagnosis and to motivate people to control PAD risk factors.

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Effects of Programmed Kinesiologic Stimulus to Hemodynamics at Peripheral Artery Disease of Lower Limbs

Acta Informatica Medica ◽

10.5455/aim.2014.22.368-370 ◽

2014 ◽

Vol 22 (6) ◽

pp. 368

Author(s):

Abel Baltic ◽

Izet Radjo ◽

Ifet Mahmutovic ◽

Indira Mahmutovic

Keyword(s):

Peripheral Artery Disease ◽

Lower Limbs ◽

Peripheral Artery ◽

Artery Disease

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Restenosis after endovascular revascularization in peripheral artery disease

VASA ◽

10.1024/0301-1526/a000440 ◽

2015 ◽

Vol 44 (4) ◽

pp. 257-270 ◽

Cited By ~ 11

Author(s):

Nasser M. Malyar ◽

Holger Reinecke ◽

Eva Freisinger

Keyword(s):

Peripheral Artery Disease ◽

Primary Patency ◽

Lower Limbs ◽

Lesion Length ◽

Success Rates ◽

Peripheral Artery ◽

Term Outcome ◽

Long Term Outcome ◽

Endovascular Revascularization ◽

Artery Disease

Abstract. Endovascular revascularization (EVR) plays a leading role in the therapy of peripheral artery disease. The acute success rates of EVR in all anatomic territories and of all TASC lesions are excellent (> 95%). However, the occurrence of restenoses after EVR such as percutaneous transluminal angioplasty and particularly after stenting, poses a substantial limitation to the success of the procedure. Influenced by patient’s comorbidities, the severity of arteriosclerotic disease, lesion length and morphology as well as the techniques and devices used for EVR, the long-term outcome of EVR deteriorates markedly from the aortoiliac to the infrapopliteal segments of the lower limbs. The development of drug-coated balloons and drug-eluting stents reduced the occurrence of restenosis leading to considerably improved primary patency rates in the femoropopliteal segments. This review aims to provide an overview about the underlying mechanisms and current relevance of the various options in the field of EVR with regard to the rate of restenosis.

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Lower extremity peripheral artery disease: a basic approach

British Journal of Hospital Medicine ◽

10.12968/hmed.2019.0263 ◽

2020 ◽

Vol 81 (3) ◽

pp. 1-9

Author(s):

Keith A Chan ◽

Alex Junia

Keyword(s):

Peripheral Artery Disease ◽

Lifestyle Changes ◽

Lower Limbs ◽

Peripheral Artery ◽

Early Administration ◽

Pressure Index ◽

Cardiovascular Morbidity And Mortality ◽

Artery Disease ◽

High Degree ◽

Progressive Disorder

Peripheral artery disease of the lower limbs is a chronically progressive disorder characterised by the presence of occlusive lesions in the medium and large arteries that result in symptoms secondary to insufficient blood flow to the lower extremities. It is both a manifestation of systemic atherosclerosis and a marker of increased cardiovascular morbidity and mortality. Because of its highly heterogenous clinical picture, a detailed history and physical assessment, a high degree of suspicion for peripheral artery disease and the use of the ankle–brachial pressure index is essential to identify patients with peripheral artery disease. This will allow early administration of basic pharmacotherapy and lifestyle changes to reduce cardiovascular events, minimise claudication symptoms and enable optimal revascularisation to prevent loss of limb function.

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Extracorporeal Blood Oxygenation and Ozonation (EBOO): A Controlled Trial in Patients with Peripheral Artery Disease

The International Journal of Artificial Organs ◽

10.1177/039139880502801012 ◽

2005 ◽

Vol 28 (10) ◽

pp. 1039-1050 ◽

Cited By ~ 24

Author(s):

N. Di Paolo ◽

V. Bocci ◽

D.P. Salvo ◽

F. Palasciano ◽

M. Biagioli ◽

...

Keyword(s):

Peripheral Artery Disease ◽

Controlled Trial ◽

Well Being ◽

Skin Lesions ◽

Blood Oxygenation ◽

Lower Limbs ◽

Controlled Clinical Trial ◽

Peripheral Artery ◽

Extracorporeal Blood ◽

Artery Disease

Background Since 1990 our group has been using extracorporeal circulation to ozonate blood by an original method, known as extracorporeal blood oxygenation and ozonation (EBOO), with the aim of amplifying the results observed with ozone autohemotherapy. Objective To verify the hypothesis that EBOO improves the skin lesions typical of peripheral artery disease (PAD) patients. Methods Twenty-eight patients with PAD were randomized to receive EBOO or intravenous prostacyclin in a controlled clinical trial. The primary efficacy parameters were regression of skin lesions and pain, and improvement in quality of life and vascularisation. Results Patients treated with EBOO showed highly significant regression of skin lesions with respect to patients treated with prostacyclin. Other parameters that were significantly different in the two groups of patients were pain, pruritus, heavy legs and well-being. No significant differences in vascularisation of the lower limbs before and after treatment were found in either group. No side effects or complications were recorded during the 210 EBOO treatments. Conclusion EBOO was much more effective than prostacyclin for treating skin lesions in PAD patients and also had a positive effect on patient general condition without any apparent change in arterial circulation. This suggests other mechanisms of action of EBOO.

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Intermittent claudication among smokers

Journal of Institute of Medicine ◽

10.3126/jiom.v31i3.2991 ◽

1970 ◽

Vol 31 (3) ◽

pp. 21-26

Author(s):

T. R. Yathish ◽

N. Annamallai ◽

V. Shankar

Keyword(s):

Intermittent Claudication ◽

Peripheral Artery Disease ◽

Population Level ◽

Lower Limbs ◽

Leg Pain ◽

Institute Of Medicine ◽

Peripheral Artery ◽

Cross Sectional ◽

Artery Disease ◽

Questionnaire Method

Introduction: Peripheral artery disease with intermittent claudication is an important cause of morbidity and mortality. Cigarette smoking is thought to be major risk factor. Currently, up to 2% of all deaths are attributable to peripheral artery disease and its complication. The economic burden associated with peripheral artery disease is also substantial. There are still significant gaps in the current understanding of the epidemiology and burden of peripheral artery disease at the population level. Methods: The aim of this study was to study intermittent claudication through survey by questionnaire method and to study risk factors of tobacco by evaluating the relationship between smokers and intermittent claudication using well accepted Rose intermittent claudication and smoking questionnaire method. This observational, descriptive, cross-sectional study was conducted in the teaching hospital of R.L. Jalappa Hospital of Sri Devaraj Urs medical college, Tamaka, Kolar, Karnataka, India during January 2004 to July 2004. A total of 130 adult men above the age of 30 years who visited the hospital with pain in the lower limbs constituted the materials for the present study. They were categorized into smokers and non-smokers. Each case was examined for lower limbs in detail and their findings were noted. Results: Participants in the group with leg pain on exertion and rest were nearly 92. Among 90 smokers, 80 had the classic symptom of intermittent claudication which started in the third decade of life whereas out of 40 non-smokers, only 12 had intermittent claudication which started after the fifth decade of life. Conclusions: Smoking not only results in early onset of intermittent claudication but also increases the risk of development of intermittent claudication by more than 80%. Keywords: Intermittent claudication, rose intermittent claudication and smoking questionnaire, smoking DOI: 10.3126/joim.v31i3.2991 Journal of Institute of Medicine, December, 2009; 31(3) 21-26

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Physiological Effects and Prescription of Exercise in Patients with Peripheral Artery Disease

Indonesian Journal of Physical Medicine & Rehabilitation ◽

10.36803/ijpmr.v10i1.279 ◽

1970 ◽

Vol 10 (1) ◽

pp. 11-21

Author(s):

Arnengsih Nazir

Keyword(s):

Blood Vessels ◽

Peripheral Artery Disease ◽

Lower Limbs ◽

Regular Exercise ◽

Physiological Effects ◽

Peripheral Artery ◽

Muscle Enzyme ◽

Supervised Exercise ◽

Walking Activity ◽

Artery Disease

ABSTRACTIntroduction: Peripheral artery disease (PAD) is a disease with atherosclerotic process in blood vessels which results in impairment of blood flow to the lower limbs. The prevalence escalates with advancing age and resulting in typical symptoms of intermittent claudication, ischemic pain at rest, non-healingwound, and atypical symptoms associated with PAD. These symptoms can lead to impaired walking, activity restrictions, and low quality of life. Regular exercise has been known as an effective intervention to reduce symptoms and improve exercise performance.Methods: Literature published from 2011-2021 was searched using the PubMed and Google Scholar as the search engine. The keywords used were exercise, physiological effect, recommendation, peripheral artery disease, and intermittent claudication.Results: Forty-four literature matched with the topic and 1 1 were used to explain sub-topics.Conclusion: The physiological effects of regular exercise include increased of oxygen extraction from blood vessels and muscle enzyme activity, as well as decreased of inflammatory mediators associated with endothelial damage. The recommended form of exercise for PAD is walking both under supervisionand without supervision at home and community. Prescription of aerobic exercise vary based on intensity targeted. Another forms of exercise recommended for PAD patients are resistance and flexibility exercises.Keywords: exercise, peripheral artery disease, physiological ef fects, supervised-exercise.

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