scholarly journals Pharmacological therapy in critically ill patients with peripheral and concomitant arteriopathy

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 166-173
Author(s):  
Nicola Troisi ◽  
Antonio Trani ◽  
Pierluigi Antonino Cappiello
Keyword(s):  
Peripheral Arterial Disease ◽  
Clinical Manifestations ◽  
Arterial Disease ◽  
Risk Profile ◽  
Pharmacological Therapy ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Critical Ischemia ◽  
Good Safety Profile ◽  
Peripheral Arterial

Peripheral arterial disease is one of the most frequent clinical manifestations of atherosclerotic disease. The clinical picture of critical ischemia of the lower limbs is often burdened by high mortality and the risk of limb amputation. The direct and indirect prostanoids, and in particular iloprost and cilostazol, are effective in the medical treatment of peripheral arterial disease. We describe here five clinical cases in which iloprost and cilostazol have been successfully administered in arterial patients with various concomitant cardiovascular diseases, highlighting a good safety profile in relation to the cardiocascular risk profile (Cardiology).

scholarly journals What Is Currently the Role of TcPO2 in the Choice of the Amputation Level of Lower Limbs? A Comprehensive Review

2021 ◽  
Vol 10 (7) ◽  
pp. 1413
Author(s):  
Judith Catella ◽  
Anne Long ◽  
Lucia Mazzolai
Keyword(s):  
Arterial Disease ◽  
Major Amputation ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Quality Of Data ◽  
Amputation Level ◽  
Increased Risk ◽  
Transcutaneous Oximetry ◽  
Peripheral Arterial

Some patients still require major amputation for lower extremity peripheral arterial disease treatment. The purpose of pre-operative amputation level selection is to determine the most distal amputation site with the highest healing probability without re-amputation. Transcutaneous oximetry (TcPO2) can detect viable tissue with the highest probability of healing. Several factors affect the accuracy of TcPO2; nevertheless, surgeons rely on TcPO2 values to determine the optimal amputation level. Background about the development of TcPO2, methods of measurement, consequences of lower limb amputation level, and the place of TcPO2 in the choice of the amputation level are reviewed herein. Most of the retrospective studies indicated that calf TcPO2 values greater than 40 mmHg were associated with a high percentage of successful wound healing after below-knee-amputation, whereas values lower than 20 mmHg indicated an increased risk of unsuccessful healing. However, a consensus on the precise cut-off value of TcPO2 necessary to assure healing is missing. Ways of improvement for TcPO2 performance applied to the optimization of the amputation-level are reported herein. Further prospective data are needed to better approach a TcPO2 value that will promise an acceptable risk of re-amputation. Standardized TcPO2 measurement is crucial to ensure quality of data.

Safety of 60-day l-arginine supplementation of patients with peripheral arterial disease of lower limbs

2015 ◽  
Vol 67 ◽  
pp. 16
Author(s):  
Natasza Balcer-Dymel ◽  
Katarzyna Korzeniowska ◽  
Artur Cieślewicz ◽  
Anna Jabłecka
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Lower Limbs ◽  
Peripheral Arterial ◽  
Arginine Supplementation

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

1997 ◽  
Vol 2 (3) ◽  
pp. 243-251 ◽  
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.

scholarly journals Beneficial Effect of Exercise on Cognitive Function during Peripheral Arterial Disease: Potential Involvement of Myokines and Microglial Anti-Inflammatory Phenotype Enhancement

2019 ◽  
Vol 8 (5) ◽  
pp. 653 ◽  
Author(s):  
Marina Leardini-Tristao ◽  
Anne-Laure Charles ◽  
Anne Lejay ◽  
Mégane Pizzimenti ◽  
Alain Meyer ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Peripheral Arterial Disease ◽  
Cognitive Dysfunction ◽  
Arterial Disease ◽  
Public Health Issue ◽  
Information Processing Speed ◽  
Critical Ischemia ◽  
Inflammatory Phenotype ◽  
Anti Inflammatory ◽  
Peripheral Arterial

Peripheral arterial disease (PAD), leading to intermittent claudication, critical ischemia with rest pain, and/or tissue damage, is a public health issue associated with significant morbidity and mortality. Little is known about the link between PAD, cognitive function, and whether exercise might reduce cognitive dysfunction in PAD patients, as previously observed concerning both quality of life and prognosis. This review highlights the fact that patients suffering from PAD often demonstrate cognitive dysfunction characterized by reduced performance in nonverbal reasoning, reduced verbal fluency, and decreased information processing speed and a greater risk for progression toward dementia. Further, the data presented support that physical exercise, likely through myokine secretion and microglial anti-inflammatory phenotype enhancement, might participate in the cognition protection in common clinical settings.

Use of Noncontact Infrared Skin Thermometer for Peripheral Arterial Disease Screening in Patients With and Without Diabetes

Angiology ◽  
2020 ◽  
Vol 71 (7) ◽  
pp. 650-657
Author(s):  
Akinori Hayashi ◽  
Masayoshi Shichiri
Keyword(s):  
Peripheral Arterial Disease ◽  
Skin Temperature ◽  
Arterial Disease ◽  
Arterial Stenosis ◽  
Limb Amputation ◽  
Diagnostic Efficiency ◽  
Operating Characteristics ◽  
Peripheral Arterial ◽  
Sensitivity Specificity ◽  
Skin Temperatures

Peripheral arterial disease (PAD) poses a threat of limb amputation and cardiovascular events. However, PAD diagnostic procedure requiring time, cost, and technical skills preclude its application as a screening test in the general population. Although PAD tends to be associated with lower foot skin temperature, none has yet to appreciate its usefulness for diagnosis/screening. We measured foot skin temperatures at the first and fifth metatarsal head and heel areas using noncontact infrared thermometer at the time of ankle brachial pressure index (ABI) measurement and limb arterial ultrasonography in 176 patients (345 legs) in participants. Foot skin temperatures correlated with ABI and showed distinctly lower levels in legs with ultrasound-confirmed arterial stenosis/occlusion and in those with ABI ≤0.90. Receiver operating characteristics analyses revealed that the lowest temperature value of the 3-foot locations had a higher sensitivity than every single location in detecting lower extremity PAD. Diagnostic efficiency for the ABI cutoff of 0.90 showed sensitivity/specificity of 41%/94%, while that for the lowest skin temperature cutoff of 30.8°C showed sensitivity/specificity of 60%/64%. In conclusion, an accurate skin temperature measurement using noncontact handheld infrared skin thermometer could serve as a new, cost-effective screening strategy for earlier diagnosis of PAD.

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