scholarly journals An audit of vascular surgery experience at North Surgical Unit, Mayo Hospital Lahore

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Khalid Irshad ◽  
Omar Salahuddin ◽  
Intesarur Rashid ◽  
Raza S ◽  
Abdul Majeed Chaudhry
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Tertiary Care ◽  
Late Presentation ◽  
Aortic Aneurysms ◽  
Peripheral Vascular ◽  
Non Invasive ◽  
Run Off ◽  
First Choice ◽  
Risk Patients

The prevalence of Peripheral vascular disease, Carotid artery stenosis and Aortic aneurysm in our society is higher than generally accepted because of higher incidence of established modifiable risk factors like Smoking, Diabetes, Hypertension and Hyperlipidaemia. We present a review of 246 patients with prospective collection of data who were referred for opinion to North Surgical Ward Mayo Hospital Lahore from March 2005 to February 2006. Surgical treatment was possible in 165 patients. Amongst remaining 81 patients 38 presented late and had amputations either in referring unit or with us and 43 were managed conservatively or under follow up. 24 prosthetic grafts were used, 8 in Aortic aneurysms, 4 in carotid endarterectomies and 11 in iliofemoral reconstructions with no peri-operative mortality or stroke. We had 2 grafts occlusion and amputations in critically ischaemic patients who had single vessel run off. Non invasive investigations were the first choice in Carotid and peripheral vascular disease. Conclusion: Our experience shows higher incidence of late presentation and under treatment of these high risk patients which need patient awareness and life style modification at community level. We advocate multidisciplinary approach and establishment of fully supported dedicated peripheral vascular and endovascular services at tertiary care level.

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

Chiropody May Prevent Amputations in Diabetic Patients on Peritoneal Dialysis

2003 ◽  
Vol 23 (3) ◽  
pp. 255-259 ◽  
Author(s):  
Jennifer Lipscombe ◽  
Sarbjit V. Jassal ◽  
Susan Bailey ◽  
Joanne M. Bargman ◽  
Stephen Vas ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Peripheral Vascular ◽  
Foot Care ◽  
Care Assessment ◽  
Patients With Diabetes

← Background A multidisciplinary approach has been shown to be of benefit in the prevention of lower limb ulceration and amputation in patients with diabetes, but there is less information on the role of such an approach in patients receiving dialysis treatment. ← Objective The purpose of the present study was to determine whether the institution of a chiropody program would result in fewer amputations in diabetic patients on peritoneal dialysis (PD). ← Design Retrospective chart review. ← Setting The PD program at a tertiary-care hospital. ← Patients Patients with diabetes that were enrolled in the PD program between January 1997 and December 1999, inclusive, that were offered the opportunity to see a chiropodist, and that agreed to be seen. A total of 132 patients were included. ← Intervention Education about foot care, assessment, and, in some instances, treatment by a chiropodist. ← Results Patients with an amputation were more likely to be male ( p < 0.01) and have peripheral vascular disease ( p < 0.001) compared to those without an amputation. They also had a lower average mean arterial pressure ( p < 0.05), lower weekly creatinine clearance ( p < 0.01), higher mean erythropoietin dose ( p < 0.05), and longer duration of end-stage renal disease ( p < 0.001). Factors that were predictive of shorter time to death or amputation were older age [hazard ratio (HR) = 1.03, p < 0.05], peripheral vascular disease (HR = 2.66, p < 0.01), and cerebrovascular disease (HR = 2.70, p < 0.01). Being seen by a chiropodist was protective (HR = 0.39, p < 0.01). ← Conclusion The current study suggests that a chiropody program may help to prevent amputation in patients with diabetes on PD.

scholarly journals A clinical study of peripheral vascular disease due to atherosclerosis in diabetic foot infections

2018 ◽  
Vol 5 (3) ◽  
pp. 931
Author(s):  
A. Tyagi ◽  
S. Lavanya ◽  
S. Lavanya ◽  
G. Hari Prasad ◽  
G. Hari Prasad
Keyword(s):  
Clinical Study ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Foot Care ◽  
Below The Knee ◽  
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. The prevalence differs among populations. This study aimed to clinical prevalence of peripheral vascular disease due to atherosclerosis in patients with diabetic foot infections presenting to this tertiary care centre.Methods: This clinical study was conducted in ASRAM hospital, Eluru, Andhra Pradesh, India. All patients admitted with a diagnosis of diabetic foot infection to the department of general surgery during a period between October 2015 to October 2017, who fulfilled the inclusion and exclusion criteria, were enrolled for the study. After recording the pertinent information (as per performa), patients were subjected to a lower limb arterial Doppler and ABPI findings were tabulated.Results: Peripheral vascular disease was found in 35% of patients studied. Majority had distal below the knee vessels stenosis or occlusion. There was significant correlation with age, history of tobacco use and various risk factors. The clinical presentations and outcomes were worse in individuals found to have peripheral vascular compromise on arterial Doppler study.Conclusions: The care of diabetic patients should start with preventive measures which include proper foot care, glycaemic control and education about diabetic foot are key factors for better out come and quality of life.

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.

Aortic and peripheral vascular disease

2010 ◽  
pp. 315-326
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Peripheral Arterial Disease ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Arterial Disease ◽  
Aortic Aneurysms ◽  
Lower Limbs ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Peripheral Vascular ◽  
Peripheral Arterial

Peripheral arterial disease 316 Aortic aneurysms 320 Aortic dissection 322 Large-vessel vasculitis 324 Peripheral arterial disease (PAD)—sometimes termed peripheral vascular disease—refers to atherosclerosis, usually of the lower limbs, with obstruction to blood supply. This usually gives rise to intermittent claudication and may progress to critical limb ischaemia characterized by rest pain, ulceration, and gangrene. Symptoms may become acutely worse due to atherothrombosis or acute embolization. PAD is increasingly recognized as a marker of arterial disease in other vascular beds as atherosclerosis is usually widespread....

3.P.342 Prevalence of peripheral vascular disease (PVD) among haemodialysis: Contribution of non-invasive explorations

1997 ◽  
Vol 134 (1-2) ◽  
pp. 270
Author(s):  
P. Leger ◽  
C. Goudable ◽  
A. Cadene ◽  
P. Cabrol ◽  
D. Lefebvre ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Non Invasive
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