scholarly journals Application of the “Trio” pharmacotherapy regimen in patients with chronic arterial insufficiency IIb-III

2020 ◽  
pp. 61-61
Author(s):  
V.V. Petrushenko ◽  
D.I. Grebeniuk ◽  
O.M. Skupyi ◽  
K.L. Lonskyi ◽  
R.I. Stoika
Keyword(s):  
Comparison Group ◽  
Lower Extremities ◽  
Sodium Lactate ◽  
Walking Distance ◽  
Peripheral Oxygen Saturation ◽  
Pressure Index ◽  
Duration Of Hospital Stay ◽  
Arterial Insufficiency ◽  
Peripheral Arterial ◽  
Experimental Group

Objective. To evaluate the effectiveness of the “Trio” pharmacotherapy regimen in patients with chronic arterial insufficiency IIb-III. Materials and methods. 45 patients with a confirmed diagnosis of peripheral arterial occlusive disease of the lower extremities and chronic arterial insufficiency IIb-III were included in the study. All patients were randomly divided into two groups. Patients from experimental group received “Trio” pharmacotherapy (multicomponent isoosmolar solution containing petoxifyllin; multicomponent hyperosmolar solution containing sodium lactate; L-arginine hydrochloridum solution). Patients from comparison group received medical therapy with multicomponent hyperosmolar solution containing sodium lactate and L-arginine hydrochloridum solution. Results and discussion. The duration of hospital stay was significantly shorter (p<0.01) in the experimental group (7.9±0.97 days) than in the comparison group (9.8±1.63 days). After treatment painless walking distance and peripheral oxygen saturation were significantly greater (p<0.01) in the experimental group (126.25±72.16 m and 90.65±5.07 %) than in the comparison group (54.20±33.59 m and 79.48±6.91 %). At the same time, and intensity of pain was significantly lower (p<0.01) in the experimental group (3.25±1.68 points) than in the comparison group (4,80±1.53 points). The values of the ankle-brachial pressure index were not differing (p<0.05) in both groups (0.49±0.16 and 0.51±0.17 for the experimental group and comparison group, respectively). Conclusions. “Trio” pharmacotherapy regimen in patients with chronic arterial insufficiency IIb-III allows to improve the basic indicators of the functional state of the microvasculature of the lower extremities.

scholarly journals Evaluation of the effectiveness of the “TRIO” pharmacotherapy regimen in patients with chronic arterial insufficiency IIb-III

2020 ◽  
Vol 3 (1) ◽  
pp. 4-9
Author(s):  
Viktoriia Petrushenko ◽  
Dmytro Hrebeniuk ◽  
Oleh Skupyi ◽  
Kostiantyn Lonskyi ◽  
Vadym Stoika
Keyword(s):  
Comparison Group ◽  
Lower Extremities ◽  
Walking Distance ◽  
Peripheral Oxygen Saturation ◽  
New Methods ◽  
Study Population ◽  
Arterial Insufficiency ◽  
Peripheral Arterial ◽  
Methods Of Treatment ◽  
Experimental Group

Background. Despite constant progress in the study of the etiopathogenetic aspects of the disease, the development and implementation of new methods of treatment, the search for optimal pharmacotherapy regimens, the problem of occlusion disease of the peripheral arteries of the lower extremities continues to be extremely relevant. The aim of the study was to evaluate the effectiveness of the “TRIO” pharmacotherapy regimen in patients with chronic arterial insufficiency IIb-III. Materials and methods. According to the aims and objectives, 45 patients with a confirmed diagnosis of peripheral arterial occlusive disease of the lower extremities and chronic arterial insufficiency IIb-III were included in the study. All patients from the study population were randomly divided into two groups. Patients from experimental group received “TRIO” pharmacotherapy (Latren, Rheosorbilact, Tivortin). Patients from comparison group received medical therapy with Rheosorbilact and Tivortin. Results. The duration of hospital stay was significantly shorter (p < 0.01) in the experimental group (7.9 ± 0.97 days) than in the comparison group (9.8 ± 1.63 days). After treatment painless walking distance and peripheral oxygen saturation were significantly greater (p < 0.01) in the experimental group (126.25 ± 72.16 m and 90.65 ± 5.07 %, respectively) than in the comparison group (54.20 ± 33.59 m and 79.48 ± 6.91 %, respectively). At the same time, the intensity of pain was significantly lower (p < 0.01) in the experimental group (3.25 ± 1.68 points) than in the comparison group (4.80 ± 1.53 points). The values of the ankle-brachial pressure index were not differing (p < 0.05) in both groups (0.49 ± 0.16 and 0.51 ± 0.17 for the experimental group and comparison group, respectively). Conclusions. “TRIO” pharmacotherapy regimen in patients with chronic arterial insufficiency IIb–III allows to improve the basic indicators of the functional state of the microvasculature of the lower extremities.

scholarly journals Evaluation of the effectiveness of the pharmacotherapy scheme “TRIO” in patients with chronic arterial insufficiency of IIb-III degree

2020 ◽  
pp. 241-242
Author(s):  
V.V. Petrushenko
Keyword(s):  
Oxygen Saturation ◽  
Comparison Group ◽  
Ankle Brachial Index ◽  
Lower Extremities ◽  
Walking Distance ◽  
Control Group ◽  
Peripheral Oxygen Saturation ◽  
Significant Difference ◽  
Arterial Insufficiency ◽  
Experimental Group

Background. Occlusive peripheral arterial disease (OPAD) of the lower extremities is a pathological condition; its pathogenetic substrate is an obstruction or narrowing of the lumen of peripheral vessels of various calibres. About 200 million people worldwide suffer from OPAD. The incidence and severity of the disease increase with age. Patients with diabetes are 2-4 times more likely to develop OPAD than those without diabetes. Smoking increases the risk of OPAD by 2.5 times. Objective. To evaluate the effectiveness of the pharmacotherapy regimen “TRIO” in patients with chronic arterial insufficiency of IIb-III degree. Materials and methods. The study included 45 people with confirmed OPAD of the lower extremities and chronic arterial insufficiency of IIb-III degree (62.2 % males, 37.8 % females, mean age – 61 years). Patients in the experimental group (n=20) were prescribed a “TRIO” scheme, which included: 1) a multicomponent isoosmolar solution containing Ringer’s lactate and pentoxifylline (200 ml per day); 2) multicomponent hyperosmolar solution containing sorbitol and sodium lactate (400 ml per day); 3) a solution of L-arginine hydrochloride (100 ml per day). Comparison group was treated by the solution 2 (200 ml per day) and solution 3 (100 ml per day) only. The effectiveness criteria included the distance of painless walking, the intensity of pain according to the visual-analogue scale (VAS), ankle brachial index, and peripheral oxygen saturation. Results and discussion. In the experimental group there was a shorter length of hospital stay (7.9±0.97 days vs. 9.8±1.63 days in the comparison group) and better dynamics of painless walking distance (1st day – 47.50±30.54 m, 7th day – 126.25±72.16 m, in the comparison group: 1st day – 49.00±27.73 m, 7th day – 54.20±33.59 m). Pain syndrome according to VAS also decreased more markedly in the experimental group: from 5.35±1.81 points on day 1 to 3.25±1.68 points on day 7 (in the comparison group – from 5.32±1.63 points on day 1 to 4.80±1.53 points on day 7). There was no significant difference in the ankle brachial index. Peripheral oxygen saturation increased more markedly in the experimental group (from 75.50±7.10 % on day 1 to 90.65±5.07 % on day 7) than in the control group (from 75.72±6.55 % on day 1 to 79.48±6.91 % on day 7). Conclusions. 1. Administration of the pharmacotherapy scheme “TRIO” allows to improve the indicators of the functional state of the vascular bed in patients with chronic arterial insufficiency of IIb-III degree. 2. Manifestations of improvement included lengthening of the distance of painless walking, increase of peripheral blood oxygen saturation, and reduction of the pain severity.

scholarly journals THE LEVEL OF SEROTONIN IN PATIENTS WITH GENERALIZED ATHEROSCLEROSIS AND ITS DYNAMICS UNDER THE INFLUENCE OF CILOSTAZOL

2020 ◽  
Vol 116 (2) ◽  
pp. 44-57
Author(s):  
Tatiana Motsak ◽  
Victor Lizogub ◽  
Elena Kupchynska ◽  
Alexey Bugaytsev
Keyword(s):  
Cognitive Function ◽  
Comparison Group ◽  
Lower Extremities ◽  
Walking Distance ◽  
Controlled Study ◽  
Open Label ◽  
Basic Therapy ◽  
Coronary Syndrome ◽  
Electrocardiographic Monitoring ◽  
The Brain

The aim of this work is to study the effect of cilostazol on regional hemodynamics, serotonin levels and functional activity of the brain, heart, lower extremities in patients with generalized atherosclerosis. A 12-week open-label, randomized, placebo-controlled study included 52 males with generalized atherosclerosis and 26 males with chronic coronary syndrome (comparison group). Patients in the generalized atherosclerosis group were randomized into two subgroups: 26 males in addition to basic therapy received cilostazol at a dose of 100 mg twice daily, and 26 patients who received additional placebo. Patients with generalized atherosclerosis had injury of four vascular territories: cerebral, coronary, mesenteric and lower extremities. It was found that in patients with generalized atherosclerosis, the level of serotonin in plasma exceeded this comparison group by 7.8 times, and a number of indicators were lower - in particular, indicators of volumetric blood flow (p<0,001), cognitive function, painless walking distance. Under the influence of treatment with the addition of cilostazol for 12 weeks before baseline therapy, the condition improved: plasma serotonin levels decreased 2,9 times (p<0,001), significantly (p<0,001) increased volumetric bold flow in all studied vascular territories, which contributed to a decrease in the number of both painful and painless episodes of myocardial ischemia (according to daily electrocardiographic monitoring), increased painless and maximum walking distance, and improved cognitive function of the brain. In the generalized atherosclerosis group, who was taking placebo, under the influence of treatment, the changes were not significant. Our data indicate a positive effect of cilostazol as an addition to basic therapy in patients with generalized atherosclerosis and the need for further research in this area.

scholarly journals Management of patients with atherosclerotic lower extremity peripheral arterial disease in the outpatient setting

2021 ◽  
Vol 10 (2) ◽  
pp. 79-82
Author(s):  
S. A. Makarov ◽  
K. V. Smirnov
Keyword(s):  
Clinical Examination ◽  
Cardiovascular Events ◽  
Comparison Group ◽  
Lower Extremities ◽  
Arterial Disease ◽  
Outpatient Setting ◽  
Main Group ◽  
Myocardial Infarctions ◽  
Audio Communication ◽  
Peripheral Arterial

Aim. To analyze and scientifically substantiate the need for the creation of a program for the outpatient observation with COZANC using remote patronage.Methods. The study prospectively included 150 patients with atherosclerosis of the arteries of the lower extremities. The average age of the patients was 68.3 ± 9.7 years. Clinical and anamnestic data were studied, and patients were interviewed using questionnaires and scales. Two observation groups were formed: the main one consisted of 70 patients, who were included in the program of remote patronage clinical examination, and 80 patients were under the standard model of outpatient observation with COZANC.Results. For a 3-month period of outpatient observation, an audio communication session was carried out for 70 patients, once a month. During the reporting period, no acute cardiovascular events were recorded in the main group, while in the comparison group there were 3 (3.75%) myocardial infarctions. The development of CLI occurred in the main group in 1 case, while in the comparison group there were 4 (5%) patients, in one case the lower limb was amputated. In the comparison group, there were 3 ischemic events that resulted in a lethal outcome.Conclusion. For the first time, a personalized remote patronage program was created and introduced into clinical practice at the level of primary health care, as a tool for optimizing the clinical examination program for patients with COZANC. The effectiveness of the remote patronage program for patients with atherosclerosis of the arteries of the lower extremities is described in relation to the prevention of acute cardiovascular events and the progression of COZANC. 

scholarly journals Diagnostic importance of pulse oximetry in the determination of the stage of chronic arterial insufficiency of lower extremities

2010 ◽  
Vol 138 (5-6) ◽  
pp. 300-304 ◽  
Author(s):  
Nebojsa Ignjatovic ◽  
Marina Vasiljevic ◽  
Dragan Milic ◽  
Jelena Stefanovic ◽  
Miroslav Stojanovic ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Arterial Oxygen Saturation ◽  
Lower Extremities ◽  
Arterial Oxygen ◽  
Critical Ischemia ◽  
High Incidence ◽  
Arterial Insufficiency ◽  
Peripheral Arterial ◽  
Diagnostic Importance

Introduction Chronic arterial insufficiency (CAI) of lower extremities is important socio-economical and healthcare problem, due to its high incidence of morbidity, disability and mortality. Objective The aim of our work was to determine the diagnostic importance of pulse oximetry in the early detection of stage of lower extremities CAI based on peripheral arterial oxygen saturation of haemoglobin (SpO2). Methods Prospectively, we analyzed a group of 50 patients, admitted at the Vascular Department of Surgical Clinic in Nis during the period from September 2006 to October 2007, with evident symptoms and signs of different stages of lower extremities CAI verified by ultrasonography. In patients with lower extremity disorder of tissue arterial capillaries, SpO2 was determined by pulse oximetry. Results Using pulse oximetry, depending on the of stage of lower extremities CAI, we revealed a considerable difference in the stages of functional ischemia SpO2: Fontaine I - 95.33?1.41%, Fontaine IIa - 92.14?2.27% and Fontaine IIb - 79.67?2.73%; in stage critical ischemia SpO2: Fontaine III - 62.54?4.39% and Fontaine IV - 47.67?6.16%. In 3 patients with gangrenous foot and fingers SpO2 was immeasurable and progressive decrease in SpO2 of arterial capillaries (p<0.01 between stages). Conclusion Due to the reliability and simplicity of pulse oximetry it can be a routinely used diagnostic device for patients with early determined stage of lower extremities CAI. .

Auricular vagal nerve stimulation in peripheral arterial disease patients

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 462-470 ◽  
Author(s):  
Gerald Hackl ◽  
Andreas Prenner ◽  
Philipp Jud ◽  
Franz Hafner ◽  
Peter Rief ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Nerve Stimulation ◽  
Short Form ◽  
Therapeutic Option ◽  
Arterial Disease ◽  
Walking Distance ◽  
Control Group ◽  
Sf 36 ◽  
Peripheral Arterial ◽  
Double Blinded

Abstract. Background: Auricular nerve stimulation has been proven effective in different diseases. We investigated if a conservative therapeutic alternative for claudication in peripheral arterial occlusive disease (PAD) via electroacupuncture of the outer ear can be established. Patients and methods: In this prospective, double-blinded trial an ear acupuncture using an electroacupuncture device was carried out in 40 PAD patients in Fontaine stage IIb. Twenty patients were randomized to the verum group using a fully functional electroacupuncture device, the other 20 patients received a sham device (control group). Per patient, eight cycles (1 cycle = 1 week) of electroacupuncture were performed. The primary endpoint was defined as a significantly more frequent doubling of the absolute walking distance after eight cycles in the verum group compared to controls in a standardized treadmill testing. Secondary endpoints were a significant improvement of the total score of the Walking Impairment Questionnaire (WIQ) as well as improvements in health related quality of life using the Short Form 36 Health Survey (SF-36). Results: There were no differences in baseline characteristics between the two groups. The initial walking distance significantly increased in both groups (verum group [means]: 182 [95 % CI 128–236] meters to 345 [95 % CI 227–463] meters [+ 90 %], p < 0.01; control group [means]: 159 [95 % CI 109–210] meters to 268 [95 % CI 182–366] meters [+ 69 %], p = 0.01). Twelve patients (60 %) in the verum group and five patients (25 %) in controls reached the primary endpoint of doubling walking distance (p = 0.05). The total score of WIQ significantly improved in the verum group (+ 22 %, p = 0.01) but not in controls (+ 8 %, p = 0.56). SF-36 showed significantly improvements in six out of eight categories in the verum group and only in one of eight in controls. Conclusions: Electroacupuncture of the outer ear seems to be an easy-to-use therapeutic option in an age of increasingly invasive and mechanically complex treatments for PAD patients.

Ankle Brachial Pressure Index and compression application: Review summary

2019 ◽  
Vol 27 (2) ◽  
pp. 74-77
Author(s):  
Victoria Team ◽  
Georgina Gethin ◽  
John D Ivory ◽  
Kimberley Crawford ◽  
Ayoub Bouguettaya ◽  
...  
Keyword(s):  
Content Analysis ◽  
Clinical Practice ◽  
Venous Insufficiency ◽  
Arterial Disease ◽  
Leg Ulcers ◽  
Current Clinical Practice ◽  
Ankle Brachial Pressure Index ◽  
Arterial Circulation ◽  
Pressure Index ◽  
Peripheral Arterial

Venous leg ulcers (VLUs) are a significant complication amongst persons with chronic venous insufficiency (CVI) that frequently follow a cycle of healing and recurrence. Current clinical practice guidelines (CPGs) recommend applying below knee compression to improve VLU healing. Compression could be applied if the Ankle Brachial Pressure Index (ABPI) rules out significant arterial disease, as sufficient peripheral arterial circulation is necessary to ensure safe compression use. We conducted a content analysis of 13 global CPGs on the accuracy of recommendations related to ABPI and compression application. Eight CPGs indicated that compression is recommended when the ABPI is between 0.8 and 1.2 mmHg. However, this review found there is disagreement between 13 global VLU CPGs, with a lack of clarity on whether or not compression is indicated for patients with ABPIs between 0.6 and 0.8 mmHg. Some CPGs recommend reduced compression for treatment of VLUs, while others do not recommend any type of compression at all. This has implications for when it is safe to apply compression, and the inconsistency in evidence indicates that specialist advice may be required at levels beyond the ABPI “safe” range listed above.

Training increases muscle blood flow in rats with peripheral arterial insufficiency

1990 ◽  
Vol 69 (4) ◽  
pp. 1353-1359 ◽  
Author(s):  
H. T. Yang ◽  
R. F. Dinn ◽  
R. L. Terjung
Keyword(s):  
Blood Flow ◽  
Muscle Blood Flow ◽  
Treadmill Running ◽  
Distal Limb ◽  
Adult Rats ◽  
Cage Activity ◽  
Exercise Hyperemia ◽  
Two Factors ◽  
Arterial Insufficiency ◽  
Peripheral Arterial

This study investigated the effect of physical training on muscle blood flow (BF) in rats with peripheral arterial insufficiency during treadmill running. Bilateral stenosis of the femoral artery of adult rats (300-350 g) was performed to reduce exercise hyperemia in the hindlimb but not limit resting muscle BF. Rats were divided into normal sedentary, acute stenosed (stenosed 3 days before the experiment), stenosed sedentary (limited to cage activity), and stenosed trained (run on a treadmill by a progressively intense program, up to 50-60 min/day, 5 days/wk for 6-8 wk). Hindlimb BF was determined with 85Sr- and 141Ce-labeled microspheres at a low (20 m/min) and high treadmill speed (30-40 m/min depending on ability). Maximal hindlimb BF was reduced to approximately 50% normal in the acute stenosed group. Total hindlimb BF (81 +/- 5 ml.min-1.100 g-1) did not change in stenosed sedentary animals with 6-8 wk of cage activity, but a redistribution of BF occurred within the hindlimb. Two factors contributed to a higher BF to the distal limb muscle of the trained animals. A redistribution BF within the hindlimb occurred in stenosed trained animals; distal limb BF increased to approximately 80% (P less than 0.001) of the proximal tissue. In addition, an increase in total hindlimb BF with training indicates that collateral BF has been enhanced (P less than 0.025). The associated increase in oxygen delivery to the relatively ischemic muscle probably contributed to the markedly improved exercise tolerance evident in the trained animals.

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