Diabetes and Old Age Could Affect Long-Term Patency of Paramalleolar Distal Bypass for Peripheral Arterial Disease in Japanese Patients

Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for simple focal lesions to multimodality techniques that enable treatment of severe arterial insufficiency. Especially for high-grade stenoses or short arterial occlusions, percutaneous transluminal angioplasty (PTA) should be the method of first choice followed by the best surgical procedure later on. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures and risk factor control is mandatory.

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To Design a Human Pbpk Model to Evaluate Cadmium Exposure Through Shellfish Consumption in Taiwan

10.21203/rs.3.rs-453395/v1 ◽

2021 ◽

Author(s):

Hao-Hsiang Ku ◽

Pham Thi Tien ◽

Min-Pei Ling

Keyword(s):

Peripheral Arterial Disease ◽

Human Health Risk ◽

Age Groups ◽

Arterial Disease ◽

Sensitivity Analyses ◽

Tubular Damage ◽

Dietary Consumption ◽

Disease Risks ◽

Peripheral Arterial

Abstract This study uses a physiology-based pharmacokinetic model to predict Cadmium (Cd) concentrations in urine and blood through shellfish consumers. The main purpose focus on assessment of human health risk to Cd through exposure via shellfish in Taiwan. A Hill-based dose-response model is utilized to estimate renal dysfunction and peripheral arterial disease risks in humans after long-term exposure. Sensitivity analyses and Monte Carlo simulations are implemented to support the risk assessment of cadmium in humans. Results indicate that glomerular and tubular damage (GTD) is different between group ages and genders ranged from 17.8067% - 17.8072%, respectively. Results show that the peripheral arterial disease prevalence (PADP) ranges from 3.2505% - 4.5968% in male and ranges from 4.7168% - 7.0152% in female, respectively. The study concludes that Cd dietary consumption is very low, for males and for females in the different age groups. This study provides a foundation that can resolve the risk dose-dependency of Cd hazard.

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Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention

PLoS ONE ◽

10.1371/journal.pone.0251542 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251542

Author(s):

Byoung Geol Choi ◽

Ji-Yeon Hong ◽

Seung-Woon Rha ◽

Cheol Ung Choi ◽

Michael S. Lee

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Peripheral Arterial Disease ◽

Significant Coronary Artery Disease ◽

Arterial Disease ◽

Term Survival ◽

Artery Disease ◽

Peripheral Arterial

Background Patients with peripheral arterial disease (PAD) have known to a high risk of cardiac mortality. However, the effectiveness of the routine evaluation of coronary arteries such as routine coronary angiography (CAG) in PAD patients receiving percutaneous transluminal angioplasty (PTA) is unclear. Methods A total of 765 consecutive PAD patients underwent successful PTA and 674 patients (88.1%) underwent routine CAG. Coronary artery disease (CAD) was defined as angiographic stenosis ≥70%. Patients were divided into three groups; 1) routine CAG and a presence of CAD (n = 413 patients), 2) routine CAG and no CAD group (n = 261 patients), and 3) no CAG group (n = 91 patients). To adjust for any potential confounders that could cause bias, multivariable Cox-proportional hazards regression and propensity score matching (PSM) analysis was performed. Clinical outcomes were evaluated by Kaplan-Meier curved analysis at 5-year follow-up. Results In this study, the 5-year survival rate of patients with PAD who underwent PTA was 88.5%. Survival rates were similar among the CAD group, the no CAD group, and the no CAG group, respectively (87.7% vs. 90.4% vs. 86.8% P = 0.241). After PSM analysis between the CAD group and the no CAD group, during the 5-year clinical follow-up, there were no differences in the incidence of death, myocardial infarction, strokes, peripheral revascularization, or target extremity surgeries between the two groups except for repeat PCI, which was higher in the CAD group than the non-CAD group (9.3% vs. 0.8%, P<0.001). Conclusion PAD patients with CAD were expected to have very poor long-term survival, but they are shown no different long-term prognosis such as mortality compared to PAD patients without CAD. These PAD patients with CAD had received PCI and/or optimal medication treatment after the CAG. Therefore a strategy of routine CAG and subsequent PCI, if required, appears to be a reasonable strategy for mortality risk reduction of PAD patients. Our results highlight the importance for evaluation for CAD in patients with PAD.

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The Role of Tobacco Cessation, Antiplatelet and Lipid-Lowering Therapies in the Treatment of Peripheral Arterial Disease

Vascular Medicine ◽

10.1177/1358863x9700200314 ◽

1997 ◽

Vol 2 (3) ◽

pp. 243-251 ◽

Cited By ~ 81

Author(s):

Alan T Hirsch ◽

Diane Treat-Jacobson ◽

Harry A Lando ◽

Dorothy K Hatsukami

Keyword(s):

Peripheral Arterial Disease ◽

Arterial Disease ◽

Pharmacological Therapy ◽

Current Data ◽

Lipid Lowering ◽

History Of ◽

Medical Therapies ◽

Peripheral Arterial ◽

Interventional Therapies

Despite the widely held belief that there are no effective medical therapies for peripheral arterial disease (PAD), current data suggest that medical therapies can effectively modify the natural history of atherosclerotic lower extremity arterial occlusive disease. The ideal medical therapy would improve claudication, forestall the onset of limb-threatening events, decrease rates of invasive interventional therapies and improve long-term patient survival. These ideal outcomes might be achieved through the use of smoking cessation interventions, including behavioral and pharmacological therapy, and the administration of antiplatelet and lipid-lowering medications in patients with PAD.

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