PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “VASCULAR DISEASES PERIPHERAL”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed1986

Pathophysiology related to peripheral vascular disease.

The problems of peripheral vascular diseases are varied and sometimes complex. The major and most common disease is arteriosclerosis obliterans. This problem will continue as the life expectancy increases. The severity of the disease compromises the quality of life. An understanding of the pathophysiologic process is necessary to enhance the quality of life and prevent the terrible and disfiguring complications which can arise as a result of insufficient knowledge.

Adult↗
PubMed1991

Exercise testing and training in patients with peripheral vascular disease and lower extremity amputation.

Patients with peripheral vascular disease have a high risk of coronary artery disease. The risk is even greater when the peripheral vascular disease leads to lower extremity amputation. Exercise testing using lower extremity exercise has been the "gold standard" for screening for coronary artery disease, but many patients with peripheral vascular disease and those with amputations have difficulty doing this type of exercise. Arm exercise ergometry has been shown to be a safe and effective alternative for the detection of coronary artery disease in patients who cannot do leg exercise. This test has also been used to determine safe exercise levels and may be able to predict the ultimate level of prosthetic use in amputees. Exercise training with arm ergometry also improves cardiovascular efficiency and upper body strength in poorly conditioned patients. Studies are needed to appreciate fully the role of exercise testing and training in the recovery of these patients after amputation.

Amputation, Surgical↗
PubMed1998

Association between human recombinant EPO and peripheral vascular disease in diabetic patients receiving peritoneal dialysis.

Peripheral vascular disease is a serious and frequent problem in diabetic patients. Since the beginning of the widespread use of erythropoietin (EPO), we have noted an increase in peripheral vascular disease in diabetic patients receiving peritoneal dialysis and erythropoietin. This prompted us to study the effects of erythropoietin on peripheral vascular disease in patients receiving peritoneal dialysis. We retrospectively reviewed medical records of all diabetic patients in our program who received peritoneal dialysis from 1990 to 1996. Demographic and laboratory data as well as EPO use data were collected. Hospital days and occurrence of vascular events (defined as peripheral vascular surgery, amputation, or recommendation of vascular surgery or amputation by a vascular surgeon) were determined for diabetic patients receiving peritoneal dialysis. Comparisons were made between those who received EPO and those who did not received EPO, as well as comparing vascular events in 28 patients who received peritoneal dialysis before and after beginning EPO. Patients who received erythropoietin were found to have a significantly shorter time to a first vascular event, a greater number of vascular events, and more hospital days associated with vascular disease than diabetic patients who did not receive erythropoietin. With multivariate analysis, significant risk factors for the development of peripheral vascular disease in these patients were erythropoietin use, erythropoietin dose, and smoking. Twenty-eight patients who initially performed peritoneal dialysis without receiving EPO, and later received EPO, had a significant increase in vascular events, including amputations only while receiving EPO. We found the use of erythropoietin to be associated with peripheral vascular events in diabetic patients who receive peritoneal dialysis. Further investigation is warranted.

Adult↗
PubMed1990

Peripheral vascular disease. Treatment with balloon angioplasty.

Peripheral vascular disease imposes daily inconveniences and limitations on many patients. The primary care physician and vascular specialist can work together to alleviate the restrictions of this disorder by prompt recognition, investigation, and therapy. It is no longer necessary to wait until patients are extremely debilitated before offering intervention. Initial success rates of percutaneous transluminal (balloon) angioplasty are very high and increasing, and restenosis rates are acceptable and decreasing. The procedure is economical and has a short convalescent period and low patient risk. Physicians should be aware that underuse of medical technology may be as costly as overuse. In upcoming years, further advances will allow even more patients with peripheral vascular disease to be treated with lesser expense; lower risk; and greater salvage of lives, limbs, and life-styles.

Activities of Daily Living↗
PubMed1989

Measurement of Doppler velocity in diagnosis of peripheral vascular disease in diabetics with peripheral pulse deficit.

Forty-nine diabetics (aged 50-69 yr, with a pulse deficit in 54 legs) were examined for peripheral vascular disease (PVD). In relation to pulse deficits PVD was proved by oscillography in 24 (44%), by qualitative Doppler velocity measurements in 19 (51%) and by quantitative Doppler in 28 (35%) cases. The overall rate of the agreement in the diagnosis between the two Doppler techniques and oscillography was 76.8% and 73.5% respectively. The differences in the PVD frequency detected by Doppler sonography were not significant. However, a comparison of Doppler deficits and pulse deficits showed that PVD was more frequently found by the qualitative Doppler technique (76.0% vs 35.2%, p less than 0.0005). Also in 94.7% of all cases PVD could be detected by the qualitative examination of only one artery. The quantitative Doppler results were directly correlated to localized findings in the foot in PVD. Thus, it can be concluded that in comparison to oscillography the qualitative Doppler velocity measurements are simpler and more time-saving for a screening diagnosis of PVD, while the quantitative technique is useful for evaluating the severity of evident PVD.

Diabetes Mellitus, Type 1↗
PubMed1998

Epidemiology of peripheral vascular disease: a predictor of systemic vascular disease.

It is estimated that peripheral vascular disease (PVD) affects 30 percent of the adult population, and two-thirds of all cases are asymptomatic. Detecting PVD can be relatively easy and inexpensive, and based either on subjectively supplied historical information (claudication) or upon physical examination findings [ankle-brachial index (ABI)]. The ABI may serve as a marker for increased risk for systemic vascular disease as an abnormally low ABI has been shown to be associated with systemic vascular disease. Epidemiology of and risk factors for PVD are in similar to coronary heart disease. PVD is uncommon until middle age and then increases dramatically. Prevalence of PVD is slightly higher in men than women, yet this tends to diminish with age. Cigarette smoking is probably the most important risk factor for PVD. Hypertension, hypercholesterolemia, and diabetes are also risk factors for the development of symptomatic PVD. Conversely, the presence of a high degree of physical activity and higher levels of HDL-cholesterol as well as a lower body mass index (BMI) are protective. Patients who have vascular disease in one organ system often exhibit evidence of vascular disease elsewhere. Presence of coronary artery disease among patients with symptomatic PVD is between two and four times higher than those without PVD, and PVD is also associated with cerebrovascular disease.

Adult↗
PubMed1989

Noninvasive and angiographic evaluation of coronary artery disease in patients with peripheral vascular disease.

The accuracy of exercise testing for detection of coronary artery disease in a population with a high incidence of claudication was evaluated in 58 consecutive patients with abdominal aortic aneurysms or lower extremity occlusive disease. Each patient was evaluated by history and physical examination, symptom-limited testing with exercise treadmill, arm ergometry and exercise radionuclide ventriculography. An algorithm was designed that retrospectively examined the results of each test in a stepwise fashion to simulate a clinical decision-making process. The results of the clinical examination, each of the exercise tests and the noninvasive diagnostic algorithm were compared with the results of coronary arteriography. The predictive accuracy of the clinical evaluation was 36%, treadmill stress testing 57%, treadmill stress plus arm ergometry 74%, exercise radionuclide ventriculography 57% and the noninvasive diagnostic algorithm 89%. When discriminant analysis was applied to all of the exercise variables, no individual test improved the accuracy of the noninvasive diagnostic algorithm. When the analysis considered only individual variables without the algorithm, the model correctly classified only 67% of the patients. Thus, accurate noninvasive evaluation of coronary artery disease is possible in patients with severe peripheral vascular disease when care is taken to design exercise protocols that allow adequate stress on the cardiovascular system.

Adult↗
PubMed1999

Cholesterol in peripheral vascular disease--a suitable case for treatment?

We assessed the prevalence of conventional risk factors for ischaemic heart disease in patients with peripheral vascular disease, and the scope for preventative treatment with lipid-lowering therapy in this group, by retrospectively reviewing 299 patients who had undergone peripheral angiography in 1996. A total of 278 patients had severe peripheral vascular disease; 44% were current smokers at the time of their angiogram, and 36% had a history of coronary artery disease (either myocardial infarction, coronary artery bypass surgery, coronary angioplasty or angina). Cholesterol had been measured in 80 (27%) patients, of whom 26 (9%) were receiving treatment for hypercholesterolaemia. Patients with a history of ischaemic heart disease were more likely to have had their cholesterol measured (50% vs. 15%; p < 0.001). Hypertension (defined as systolic > 160 mmHg or diastolic > 90 mmHg) was present in 44%. There was no difference in the distribution of risk factors between those with and those without known ischaemic heart disease. There is a high prevalence of modifiable risk factors for coronary disease in patients with severe peripheral vascular disease. Effective prevention is available for coronary artery disease, but we found low levels of treatment. There is considerable scope for intervention to reduce the risk of coronary disease in such patients.

Aged↗
PubMed2002

A review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors.

Peripheral vascular disease (PVD) is a common condition often associated with cardiovascular risk factors and events. With the aid of B-mode ultrasound scanning, evidence is emerging that these risk factors and events are significantly related to an increased carotid and femoral intima-media thickness (IMT). More importantly, treatment of these risk factors is associated with a decrease or a diminished progression of the IMT, paralleled by a reduction in cardiovascular events and an improvement in the symptoms associated with PVD. This evidence is particularly strong for lipid lowering therapy. Additional predictors of cardiovascular risk like the IMT, could now influence the decision to intervene with medication.

Age Factors↗
PubMedDate not supplied

Intravenous digital subtraction angiography in the management of peripheral vascular disease.

All patients undergoing peripheral injection intravenous digital subtraction angiography (ivDSA) for peripheral vascular disease during 1987 have been reviewed (140 patients). The radiological distribution of disease was aorto-iliac occlusive (AI) 36 (23%), femoropopliteal (FP) 68 (44%), mixed AI/FP 36 (23%). Clinical diagnosis was correct for AI disease in 92%, for FP disease in 65% and for mixed AI/FP disease in 47%. ivDSA was the only investigation required for management in 111 of all 140 patients (79%), and in 33 of the 36 patients with AI disease (92%), but was less accurate in defining femoropopliteal disease, 22 patients (32%) requiring additional arteriography. Conventional arteriography was performed in 200 patients in 1982 compared with 100 in 1987. ivDSA is particularly suitable for the investigation of AI disease, a condition which is accurately detected by clinical examination, with a reduction in morbidity and bed occupancy.

Angiography, Digital Subtraction↗
PubMed1992

Evaluation of leg perfusion during exercise using technetium 99m sestamibi. A new test for peripheral vascular disease.

Thirty patients with occlusive peripheral vascular disease underwent clinical examination, segmental blood pressure determinations, intra-arterial digital subtraction angiography, and treadmill stress testing with injection of technetium 99m sestamibi at peak exercise. Radionuclide images of the thighs, calves, and feet showed clear delineation of major muscle groups. Diminished radiotracer distribution was closely correlated with the presence of occlusive vascular disease on angiography and with the presence of claudication and reduced segmental blood pressure. A quantitative scheme based on pixel intensity was developed to compare areas of regional perfusion.

Arteriosclerosis↗
PubMed1982

Beta-adrenergic blockade and peripheral vascular disease.

Hypertension and ischaemic heart disease are common accompaniments of peripheral vascular disease, and are often treated with beta-blocking drugs. Previous reports, however, have suggested that these drugs may aggravate peripheral vascular disease. A study was designed to investigate this problem with claudication-distance and skin and muscle blood-flow studies (as determined by 133Xe clearance) as indices for assessment. In all 11 patients who presented with features of peripheral vascular disease and were found to be taking beta-blocking drugs, administration of the drug was stopped, blood pressure was controlled by other means, and the situation was reassessed four weeks later. There was a significant improvement in claudication distance and in resting and post-exercise muscle blood flow after withdrawal of the drug. This held for both cardioselective and nonselective beta-blockers. It is recommended that this group of drugs be avoided in the treatment of patients with peripheral vascular disease.

Adrenergic beta-Antagonists↗
PubMed1991

Near-infrared spectroscopy in peripheral vascular disease.

Near-infrared spectroscopy has been performed on the calf muscles of 38 subjects, 21 normal controls without vascular disease and 17 patients with peripheral vascular disease. Oxygen consumption was measured in the calf by calculating the rate of conversion of oxyhaemoglobin to deoxyhaemoglobin during a period of tourniquet-induced ischaemia. Postischaemic reoxygenation was also measured. Median oxygen consumption in patients with peripheral vascular disease was 0.10 ml 100 g tissue-1 min-1, while in the control group it was 0.20 ml 100 g tissue-1 min-1 (P less than 0.03, Mann-Whitney U test). The median time taken to reach maximum oxyhaemoglobin levels after ischaemia was 40 s in patients with peripheral vascular disease and 20 s in controls (P less than 0.02). The results indicate that oxygen consumption is reduced in peripheral vascular disease. Near infrared spectroscopy is a non-invasive method for assessing metabolic improvement resulting from surgical or pharmacological treatment.

Adult↗