scholarly journals Evaluation of Patients with Lower Extremity Peripheral Artery Disease by Walking Tests: A Pilot Study

2017 ◽  
Vol 9 (4) ◽  
pp. 467-473 ◽  
Author(s):  
Andra CIOCAN ◽  
Răzvan A. CIOCAN ◽  
Claudia D. GHERMAN ◽  
Sorana D. BOLBOACĂ
Keyword(s):  
Lower Extremity ◽  
Arterial Disease ◽  
Leg Pain ◽  
Walking Ability ◽  
Treadmill Test ◽  
Walking Test ◽  
Randomized Design ◽  
Walking Tests ◽  
Peripheral Arterial ◽  
Surgery Department

Peripheral arterial disease (PAD) directly affects the quality of life, patients experimenting limited walking ability and disability. The purpose of the current study was to investigate the walking and climbing patterns of patients with lower extremity PAD in relation with several risk factors, applied on Romanian population. A cohort non-randomized design was conducted and all eligible subjects who self-referred for medical care since March 2016 until February 2017 at the Second Surgery Department, County Clinical Emergency Hospital of Cluj-Napoca were included. The eligible patients were older than 18 years, with leg pain and Rutherford grade from I to IV. The following tests were applied to each subject included in the study to investigate the capacity to walk as far as possible in six minute (6 minute walking test), the capacity to climb stairs (climbing stairs test) and the capacity to walk on a treadmill (treadmill test) until the pain occurred. Twenty-four patients with mean age of 65.08±8.53 years were investigated. Almost 81% of patients were with chronic pain, 46% were overweight, and 79% were smokers. The results on applied walking tests were as follows: 279.17±70.58 meters to 6-minutes walking test, 77.50±21.80 stairs and 182.50±73.34 meters on treadmill test. The results of the walking tests significantly correlate with each other (ρ>0.93, p<0.0001), and all applied tests significantly correlate with toe gangrene (ρ>|0.52|, p<0.01) and toe disarticulation (ρ>0.62, p<0.002). It can be concluded that any of the applied walking test proved reliable instrument, able to identify the patients with most severe PAD.

How Admission to a Vascular Surgery Department Improves Medical Treatment in Patients with Lower Extremity Peripheral Arterial Disease

2017 ◽  
Vol 40 ◽  
pp. 85-93 ◽  
Author(s):  
Martina Thiney ◽  
Nellie Della Schiava ◽  
Patrick Feugier ◽  
Patrick Lermusiaux ◽  
Jacques Ninet ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Lower Extremity ◽  
Vascular Surgery ◽  
Medical Treatment ◽  
Arterial Disease ◽  
Peripheral Arterial ◽  
Surgery Department

Evaluation of Leg Pain

2015 ◽  
Author(s):  
Martyn Knowles
Keyword(s):  
Lower Extremity ◽  
Ankle Brachial Index ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Cardiac Risk ◽  
Multiple Organ ◽  
Leg Pain ◽  
Acute Limb Ischemia ◽  
Organ Systems ◽  
Peripheral Arterial

Few patient complaints offer such a large range of acuity and differential diagnoses as the complaint of leg pain. This is in part due to the multiple organ systems at play, including cardiac, pulmonary, musculoskeletal, neurologic, vascular, and dermatologic. The surgeon is frequently presented with the challenge of identifying and managing these complaints in a variety of settings. Management involves a spectrum from conservative care to surgical intervention where appropriate. The wide array of symptoms, signs, and often contradictory test results can be confusing and frustrating to patients and physicians alike, leading to delays and errors in diagnosis and ineffective management. This review offers a sequential and ordered approach to the evaluation of leg pain. Tables highlight atherosclerotic risk factors, vascular causes of lower extremity pain, the classification of acute limb ischemia, the ankle-brachial index and corresponding peripheral arterial disease, and the revised cardiac risk score for preoperative risk. Figures show bilateral lower extremity ischemia, chronic ischemic changes to the foot, classic dry gangrene, wet gangrene, acute limb ischemia, Charcot foot, segmental waveform and pulse volume recording analysis of the bilateral lower extremities, and angiographic evaluation of patients with aortoiliac and tibial disease. This review contains 10 figures, 5 tables, and 55 references.

Clinical factors and mortality rates for non-traumatic upper extremity amputations

2021 ◽  
pp. 175319342110427
Author(s):  
Yong-Zheng Jonathan Ting ◽  
An-Sen Tan ◽  
Chi-Peng Timothy Lai ◽  
Mala Satku
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Significant Risk ◽  
Arterial Disease ◽  
Mortality Rates ◽  
Level Of Evidence ◽  
Peripheral Arterial ◽  
Extremity Amputation

Non-traumatic upper extremity amputations are an increasing concern with the rising prevalence of diabetes mellitus. To ascertain the risk factors and mortality rates for these amputations, the demographic information, amputation history, comorbidities and clinical outcomes of 140 patients who underwent non-traumatic upper extremity amputations between 1 January 2004 and 31 October 2017 were studied. Correlations were assessed using Cochran-Armitage chi-squared tests, odds ratios and multivariate binomial logistic regression as appropriate. Diabetes mellitus, coronary artery disease, end-stage renal failure, peripheral arterial disease and prior lower extremity amputation were significant risk factors for multiple upper extremity amputations. One-year, 2-year and 5-year mortality rates were 12%, 15% and 38%, respectively, following first upper extremity amputation. The risk factors for upper extremity amputations correspond with those for lower extremity amputations, comprising mainly diabetes mellitus and its related comorbidities. The mortality rates for non-traumatic upper extremity amputations highlight their significant burden on patients. Level of evidence: III

scholarly journals Norwegian trends in numbers of lower extremity revascularisations and amputations including regional trends in endovascular treatments for peripheral arterial disease: a retrospective cross-sectional registry study from 2001 to 2014

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016210 ◽  
Author(s):  
Kjersti Wendt ◽  
Ronny Kristiansen ◽  
Kirsten Krohg-Sørensen ◽  
Fredrik Alexander Gregersen ◽  
Erik Fosse
Keyword(s):  
Lower Extremity ◽  
Arterial Disease ◽  
Major Amputation ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
Cross Sectional ◽  
Regional Trends ◽  
Treatment Knowledge ◽  
Patients With Diabetes ◽  
Peripheral Arterial

ObjectiveThe numbers of lower extremity revascularisations and amputations are insufficiently reported in Norway. To support future policy decisions regarding the provision of vascular treatment, knowledge of such trends is important.MethodsThis retrospective cross-sectional study from 2001 to 2014 used data from the Norwegian Patient Registry. The revascularisation treatments were categorised in multilevel, aortoiliac, femoral to popliteal and popliteal to foot levels and sorted as open, endovascular and hybrid. The sessions in amputations were divided in major (thigh and below knee) and minor (ankle, foot or digit). Incidence rates were assessed per 100 000 for patients in the age group>60 years. The diabetic prevalence was calculated and the endovascular numbers at the South-Eastern, Western, Central and Northern Norway Regional Health Authority were compared.ResultsThe overall revascularisation rates increased from 308.7 to 366.8 (p=0.02). Open revascularisations decreased from 158.9 to 98.7 (p<0.01) while endovascular revascularisations increased from 142.2 to 243.4 (p<0.01). Hybrid revascularisations increased from 7.4 to 24.8 (p<0.01). Major amputation rates decreased from 87.8 to 48.7 (p<0.01) while minor amputations increased from 12.3 to 19.6 (p=0.01). The diabetic percentages increased from 12.2 to 22.3 (p<0.01) in revascularisations, from 26.5 to 30.8 (p=0.02) in major amputations and from 43.0 to 49.3 (p=0.13) in minor. (p values refer to average annual changes.) The regional trends in endovascular treatments varied within and between the vascular groups.ConclusionFrom 2001 to 2014, the revascularisation rates increased due to the rise in endovascular procedures. Open revascularisations and major amputation rates decreased, minor increased. The regional variances in endovascular treatments indicate that the availability of this technology differed between the health regions of Norway. The increase in patients with diabetes requires continued awareness of diabetes and its complications.

Sign in / Sign up

Export Citation Format

Share Document