DOI: http://dx.doi.org/10.18203/2349-2902.isj20181116

Clinical study of peripheral arterial occlusive disease of lower extremities

Prasad C., Santosh Nayak K.

Abstract


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.


Keywords


Acute limb ischemia, Atherosclerosis, Peripheral arterial disease, Vascular disease

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References


Ouriel K. Detection of Peripheral arterial disease in primary care. JAMA. 2001 Sep;286:1380-1.

Hiatt WR. Medical treatment of peripheral arterial disease and claudication. N Eng J Med. 2001;344:1608-21.

De Palma RG. Atherosclerosis: Pathology, pathogenesis and medical management, 6th Ed. In: Moore WS, editor. Vascular Surgery: A Comprehensive Review. Philadelphia: WB Saunders Company; 2002:91-104.

Nehler MR, Taylor LM, Moneta GL, Porter JM. Natural history and non-operative treatment of chronic lower extremity ischemia. 6th Ed. In: Moore WS, editor. Vascular Surgery: A Comprehensive Review. Philadelphia: WB Saunders Company; 2002:264-275.

Jaap AJ, Tooke JE. Diabetic angiopathy and Diabetic foot. In: Tooke JE, Lowe GDO, editors. A textbook of vascular medicine. London: Arnold; 1996:254-71.

Faries PL, Teodorescu VJ, Morrissey NJ, Hollier LA, Marin ML. The role of surgical revascularization in management of Diabetic foot wounds. Am J Surg. 2004 May;187(5A):34-7.

Criquis MH, Denenberg JO, Bird CE, Fronek A, Klauber MR, Langer RD. The correlation between symptoms and non-invasive test results in patients referred for Peripheral Arterial Disease testing. Vasc Med. 1996;65-71.

Selvin E, Erlinger TP: Prevalence of and risk factors for peripheral arterial disease in the Unites States: Results from the National Health and Nutrition Examination Survey 1999-2000. Circulation. 2004;110:738-43.

Sigvant B, Wiberg-Hedman K, Bergqvist D. A population-based study of peripheral arterial disease prevalence with special focus on critical limb ischemia and sex differences. J Vasc Surg. 2007;45:1185-91.

Nigam R. The clinical profile of TAO and Arteiosclerosis obliterans. Ind J Surg. 1980;42:225.

Mills JL, Porter JM. Buerger’s Disease: A review and update. Semin Vasc Surg. 1993;6:14-23.

Olin JW, Young JR, Graor RA. The changing clinical spectrum of thromboangititis obliterans (Buerger’s disease). Circulation 1990;825(4):3-8.

Kannel WB, Shurleff D. The natural history of Arteriosclerosis Obliterans. Cardiovasc Clin. 1971;3:37-52.

Hill GL, Moeliono F, Tomewu D, Bratanada, Tohardi A. The Buerger’s syndrome in Java. A description of the clinical syndrome and some aspects of its etiology. Br J Surg. 1973;60(8):606-13.

Kannel WB, McGee DL. Update on some epidemiologic features of intermittent claudication: the Framingham Study. J Am Geriatr Soc. 1985;33:13-8.

Beks PJ, Mackaay AJ, de Neeling JN. Peripheral arterial disease in relation to glycaemic level in an elderly Caucasian population: the Hoorn study. Diabetol. 1995;38:86-96.

Hertzer NR, Beven EG, Young JR. Coronary artery disease in peripheral vascular patients: a classification of 1000 coronary angiograms and results of surgical management. Ann Surg. 1984;199:223-33.

Sasaki S, Sakuma M, Kunihara T, Yasuda K. Distribution of arterial involvement in thromboangititis obliterans (Buerger’s disease): Results of a study conducted by the Intractable Vasculitis Syndromes Research Group in Japan. Surg Today. 2000;30:600-5.

Jonason T, Bergstrom R. Cessation of smoking in patients with intermittent claudication: effects on the risk of peripheral vascular complications, myocardial infarction and mortality. Acta Med Scand. 1987;221(3):253-60.

Lonardi R. Long-term mortality and its predictors in patients with critical leg ischaemia. European J Vasc Endovasc Surg. 1997;14:91-5.

Persson AV, Anderson LA, Padberg FT Jr. Selection of patients for lumbar sympathectomy. Surgical Clin North Am. 1985;65:393.