Peripheral arterial occlusive disease and ischemic disease of the lower limbs are not the same condition. A proposed unambiguous Italian terminology for defining Peripheral arterial disease of lower limbs and related clinical/therapeutic implications

Background: Peripheral arterial occlusive disease or commonly known as peripheral arterial disease (PAD) comprises those entities which result in obstruction to blood flow in the arteries, exclusive of the coronary and intracranial vessels and the term is usually applied to disease involving the arteries of lower extremity. Peripheral arterial disease is an important manifestation of atherosclerosis involving the arteries of legs. Vascular surgeons continue to encounter complications of atherosclerosis as their most common clinical challenge. Objective of this study was to know the various etiologies and different clinical presentation of Peripheral arterial occlusive disease.Methods: This was a cross sectional observational study of 50 cases diagnosed with Peripheral Arterial disease of the lower extremities, done during the period from January 2013 to June 2014 among the Patients with Peripheral Arterial disease of the lower extremities admitted to surgical wards of SCBMCH, Cuttack.Results: All the cases in the present study fall under the category of chronic lower limb ischemia and no cases of acute limb ischemia. Majority of the cases in atherosclerosis were above the age of 50 years, while in the TAO group majority belong to the age group between 31 to 50 years. TAO was usually limited to the distal part of the limb. All patients with TAO had a history of smoking and 61% of atherosclerotic patients gave history of smoking.Conclusions: TAO and Atherosclerosis are the etiologies for ischemia in these cases, with atherosclerosis being more common of the two. TAO presented at a younger age group whereas atherosclerosis presented in the older age group.

Download Full-text

Peripheral Arterial Disease Study (PERART): Prevalence and predictive values of asymptomatic peripheral arterial occlusive disease related to cardiovascular morbidity and mortality

BMC Public Health ◽

10.1186/1471-2458-7-348 ◽

2007 ◽

Vol 7 (1) ◽

Cited By ~ 37

Author(s):

María Teresa Alzamora ◽

◽

José Miguel Baena-Díez ◽

Marta Sorribes ◽

Rosa Forés ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Peripheral Arterial Occlusive Disease ◽

Arterial Disease ◽

Arterial Occlusive Disease ◽

Cardiovascular Morbidity ◽

Morbidity And Mortality ◽

Predictive Values ◽

Cardiovascular Morbidity And Mortality ◽

Peripheral Arterial ◽

Disease Study

Download Full-text

Pulmonary V̇o2 dynamics during treadmill and arm exercise in peripheral arterial disease

Journal of Applied Physiology ◽

10.1152/japplphysiol.00612.2003 ◽

2004 ◽

Vol 97 (2) ◽

pp. 627-634 ◽

Cited By ~ 22

Author(s):

Timothy A. Bauer ◽

Eric P. Brass ◽

Mark Nehler ◽

Thomas J. Barstow ◽

William R. Hiatt

Keyword(s):

Blood Flow ◽

Peripheral Arterial Disease ◽

Treadmill Exercise ◽

Arterial Disease ◽

Occlusive Disease ◽

Lower Limbs ◽

Whole Body ◽

Moderate Intensity ◽

Arm Exercise ◽

Peripheral Arterial

Slowed pulmonary O2 uptake (V̇o2) kinetics in peripheral arterial disease (PAD) have been attributed to impaired limb blood flow and/or peripheral muscle metabolic abnormalities. Although PAD results from atherosclerotic occlusive disease in the arteries to the lower extremities, systemic abnormalities affecting whole body O2 delivery or vascular function in PAD could also partially explain the exercise impairment. To date, the effects of these systemic abnormalities have not been evaluated. To test the hypothesis that the slowed pulmonary V̇o2 kinetics in PAD reflects local and not systemic abnormalities, V̇o2 kinetics were evaluated after the onset of constant-load exercise of the upper and lower limbs in PAD patients and healthy controls (Con). Ten PAD patients and 10 Con without significant cardiopulmonary dysfunction performed multiple transitions from rest to moderate-intensity arm ergometry and treadmill exercise to assess their V̇o2 kinetic responses. Reactive hyperemic (RH) blood flow was assessed in the arms and legs as a measure of endothelial function. Compared with Con, PAD V̇o2 kinetic phase 2 time constants were prolonged during treadmill exercise (PAD 34.3 ± 9.2 s vs. Con 19.6 ± 3.5 s; P < 0.01) but not arm exercise (PAD 38.5 ± 7.5 s vs. Con 32.5 ± 9.0 s; P > 0.05). RH blood flow was significantly reduced in the legs (PAD 20.7 ± 8.3 vs. Con 46.1 ± 17.1 ml·100 ml−1·min−1; P < 0.01) and arms of PAD subjects (PAD 34.0 ± 8.6 vs. Con 50.8 ± 12.2 ml·100 ml−1·min−1; P < 0.01) compared with Con, but RH limb flow was not correlated with arm or treadmill V̇o2 kinetic responses in either group. In summary, slowed pulmonary V̇o2 kinetics in PAD patients occur only with exercise of the lower limbs affected by the arterial occlusive disease process and are not slowed with exercise of the unaffected upper extremities compared with controls. Furthermore, the slowed pulmonaryV̇o2 kinetics of the lower extremity could not be explained by any abnormalities in resting cardiac or pulmonary function and were not related to the magnitude of reduction in limb vascular reactivity.

Download Full-text

Noninvasive Vascular Laboratory for Evaluation of Peripheral Arterial Occlusive Disease. Part III—Clinical Applications: Nonatherosclerotic Lower Extremity Arterial Conditions and Upper Extremity Arterial Disease

Journal of Vascular and Interventional Radiology ◽

10.1016/s1051-0443(07)61395-5 ◽

2001 ◽

Vol 12 (1) ◽

pp. 11-18 ◽

Cited By ~ 10

Author(s):

Steven C. Rose

Keyword(s):

Lower Extremity ◽

Upper Extremity ◽

Peripheral Arterial Occlusive Disease ◽

Arterial Disease ◽

Clinical Applications ◽

Arterial Occlusive Disease ◽

Occlusive Disease ◽

Vascular Laboratory ◽

Peripheral Arterial

Download Full-text

MTHFR 677C>T (rs1801133) variant is associated with homocysteinemia but not with clinical severity in patients with peripheral arterial occlusive disease

10.21203/rs.3.rs-887964/v1 ◽

2021 ◽

Author(s):

Guilherme da Silva Silvestre ◽

Iriana Moratto Carrara ◽

Tamires Flauzino ◽

Marcell Alysson Batisti Lozovoy ◽

Rubens Cecchini ◽

...

Keyword(s):

Peripheral Arterial Occlusive Disease ◽

Clinical Stage ◽

Serum Levels ◽

Arterial Disease ◽

Recessive Model ◽

Arterial Occlusive Disease ◽

Occlusive Disease ◽

Clinical Severity ◽

University Hospital ◽

Peripheral Arterial

Abstract The aim of this study was to evaluate the association between the MTHFR 677C > T (rs1801133) genetic variant with susceptibility and severity of peripheral arterial occlusive disease (PAOD) and with serum levels of homocysteine (Hcy). This case-control study enrolled 157 patients with PAOD attended at University Hospital of Londrina, and unrelated 113 healthy individuals from Southern Brazil. The clinical severity of the PAOD patients was assessed by Fontaine classification and anatomoradiological categories by Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC). The MTHFR 677C > T was genotyped using real-time polymerase chain reaction. The PAOD patients showed higher Hcy than controls but the Hcy did not differ according to Fontaine and TASC categories. Patients carrying the TT genotype (recessive model) or CT + TT (dominant model) presented higher levels of Hcy than those carrying other genotypes. In conclusion, the T allele of MTHFR 677C > T variant was associated with hyperhomocysteinemia in PAOD patients, but not in controls. Moreover, this variant was not associated with the clinical stage and the anatomoradiological categories of PAOD. Our data suggested a possible interaction between MTHFR 677C > T variant and the presence of other genetic, epigenetic and environment factors associated with PAOD on modulation the metabolism of Hcy.

Download Full-text