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Intermittent claudication

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https://www.readbyqxmd.com/read/27908805/understanding-patient-acceptance-of-risk-with-treatment-options-for-intermittent-claudication
#1
Abigail Hm Morbi, Sophie Coles, Mostafa Albayati, Ian M Nordon, Cliff Shearman
OBJECTIVES: Intermittent claudication has a major impact on the quality of life and functional ability of the patient. However, when treating these patients, management is largely influenced by vascular surgeons' perceptions of risk. There is little information available regarding the level of risk that patients perceive to be acceptable, when considering complications of treatment. This study investigates patients' acceptance of risk associated with current management options for intermittent claudication and explores factors associated with greater risk acceptance...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903955/effect-of-diabetes-mellitus-on-walking-distance-parameters-after-supervised-exercise-therapy-for-intermittent-claudication-a-systematic-review
#2
David Hageman, Lindy Nm Gommans, Marc Rm Scheltinga, Joep Aw Teijink
Some believe that certain patients with intermittent claudication (IC) may be unsuitable for supervised exercise therapy (SET), based on the presence of comorbidities and the possibly increased risks. We conducted a systematic review (MEDLINE, EMBASE and CENTRAL) to summarize evidence on the potential influence of diabetes mellitus (DM) on the response to SET. Randomized and nonrandomized studies that investigated the effect of DM on walking distance after SET in patients with IC were included. Considered outcome measures were maximal, pain-free and functional walking distance (MWD, PFWD and FWD)...
November 30, 2016: Vascular Medicine
https://www.readbyqxmd.com/read/27890849/hybrid-treatment-of-a-suprarenal-aortic-aneurysm-with-an-infrarenal-aorto-bifemoral-surgical-graft-and-a-fenestrated-stent-graft
#3
Sebastian Nagel, Athanasios Katsargyris, Kyriakos Oikonomou, Eric L G Verhoeven
PURPOSE: To report a hybrid technique for the treatment of a suprarenal aortic aneurysm (SAA) in a patient with iliac occlusive disease. Initially an infrarenal aorto-bifemoral surgical graft was implanted, followed by deployment of a fenestrated bifurcated stent-graft at the suprarenal part of the aorta. CASE REPORT: A 69-year old man presented with a 51-mm saccular SAA and iliac occlusive disease with intermittent claudication. Both common iliac arteries had been previously treated with kissing stents...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27872352/additional-functional-outcomes-after-endovascular-treatment-for-intermittent-claudication
#4
Anne Sofie F Larsen, Morten B Jacobsen, Jarlis Wesche, Nils Einar Kløw
BACKGROUND: Endovascular treatment (EVT) for intermittent claudication (IC) is performed in selected patients where conservative treatment and training fail. Treatment outcomes reported in vascular registries (survival, limb-survival, and re-intervention rate) are inadequate for low-risk patients with IC. Additional measurements of blood flow reduction and functional impairment clarify the indication for treatment and facilitate outcome evaluation. PURPOSE: To analyze the additional outcome information on peripheral arterial pressures and walking capacity obtained from a local registry of EVT...
November 21, 2016: Acta Radiologica
https://www.readbyqxmd.com/read/27866700/angiopoietin-related-growth-factor-is-independently-associated-with-lower-extremity-peripheral-arterial-disease
#5
Hao Nie, Yue Liang, Hong-Xia Wang, Hua-Liang Ren, Yue-Wei Wang, Fang-Da Li, Yue-Hong Zheng
AIMS: The present study investigated the association of serum levels of angiopoietin-related growth factor (AGF) with lower extremity peripheral arterial disease (LEPAD). METHODS: The study group is comprised of 105 patients with lower extremity peripheral arterial disease. The control group consisted of 80 individuals without lower extremity peripheral arterial disease. Serum AGF concentrations were determined by enzyme-linked immunosorbent assay. The relationship between AGF and clinical and biochemical parameters was studied...
October 27, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27833919/the-impact-of-walking-exercises-and-resistance-training-upon-the-walking-distance-in-patients-with-chronic-lower-limb-ischaemia
#6
Maria Szymczak, Grzegorz Oszkinis, Marian Majchrzycki
Objective. The objective of this paper is to compare the impact of supervised walking and resistance training upon the walking distance in PAD patients. Materials and Methods. The examination involved 50 PAD patients at the 2nd stage of the disease according to Fontaine's scale. The participants were randomly allocated to two groups: one exercising on the treadmill (n = 24) and one performing resistance exercises of lower limbs (n = 26). Results. The 12-week program of supervised rehabilitation led to a significant increase in the intermittent claudication distance measured both on the treadmill and during the 6-minute walking test...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27813474/-cyclic-nucleotide-phosphodiesterases-role-in-the-heart-and-therapeutic-perspectives
#7
Ibrahim Bedioune, Pierre Bobin, Sarah Karam, Marta Lindner, Delphine Mika, Patrick Lechêne, Jérôme Leroy, Rodolphe Fischmeister, Grégoire Vandecasteele
Cyclic nucleotide phosphodiesterases (PDEs) degrade the second messengers cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), thereby regulating multiple aspects of cardiac function. This highly diverse class of enzymes encoded by 21 genes encompasses 11 families that are not only responsible for the termination of cyclic nucleotide signalling, but are also involved in the generation of dynamic microdomains of cAMP and cGMP, controlling specific cell functions in response to various neurohormonal stimuli...
2016: Biologie Aujourd'hui
https://www.readbyqxmd.com/read/27799941/diffuse-arterial-thrombosis-as-a-first-manifestation-of-occult-malignancy
#8
Marija Vavlukis, Irina Kotlar, Emilija Chaparoska, Emilija Antova, Sasko Kedev
Aim. To raise the awareness of a hypercoagulability state as it is often associated with the different types of malignancies. Venous thromboembolism is a frequent complication in these patients, and usually it happens after the diagnosis of cancer is confirmed. However, hypercoagulability disorders presenting as the first symptoms or signs in the cancer patients have rarely been reported. Furthermore, arterial thrombosis is extremely rare even in cancer patients. Method. Review of the case characteristics and literature review...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27769867/factors-associated-with-sedentary-behavior-in-patients-with-intermittent-claudication
#9
B Q Farah, R M Ritti-Dias, G G Cucato, P S Montgomery, A W Gardner
OBJECTIVES: Time spent in sedentary behavior has been associated with cardio-metabolic risk factors in the general population and in patients with symptomatic peripheral artery disease (PAD). Given the association of sedentary behavior and poor health outcomes, it is important to identify factors associated with sedentary behavior in these patients. The aim of this study was to identify factors associated with the sedentary time in patients with symptomatic PAD. METHODS: The sample included 297 patients with symptomatic PAD...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27764750/changes-of-posture-and-muscle-activities-in-the-trunk-and-legs-during-walking-in-patients-with-lumbar-spinal-stenosis-after-decompression-surgery-a-preliminary-report
#10
Tsuyoshi Goto, Toshinori Sakai, Tetsuya Enishi, Nori Sato, Koji Komatsu, Koichi Sairyo, Shinsuke Katoh
Neurogenic intermittent claudication is a main symptom in lumbar spinal stenosis (LSS), and postural change is often observed during walking. This study aimed to identify the changes in posture and muscle activity in the trunk and legs during walking in patients with LSS by examining 6 patients who had undergone decompression surgery. None of them had significant paralysis. Gait analysis using Vicon motion capture system(®) with electromyographic recordings of the paravertebral muscles (PVM) and vastus lateralis muscle (VL) was performed preoperatively and 2 weeks postoperatively...
January 2017: Gait & Posture
https://www.readbyqxmd.com/read/27763685/long-term-outcomes-of-a-randomized-clinical-trial-of-supervised-exercise-percutaneous-transluminal-angioplasty-or-combined-treatment-for-patients-with-intermittent-claudication-due-to-femoropopliteal-disease
#11
F A K Mazari, J A Khan, N Samuel, G Smith, D Carradice, P C McCollum, I C Chetter
BACKGROUND: The aim was to compare the long-term outcomes of percutaneous transluminal angioplasty (PTA), a supervised exercise programme (SEP) and combined treatment (PTA + SEP) in patients with intermittent claudication owing to femoropopliteal disease. METHODS: Patients recruited to an RCT comparing these treatments were invited for long-term follow-up from 2010 to 2011. Indicators of limb ischaemia were recorded (ankle : brachial pressure index (ABPI) and treadmill walking distances)...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27763293/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-current-smokers-with-intermittent-claudication-and-critical-limb-ischemia
#12
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Roy M Fujitani
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27760274/effectiveness-of-a-medical-vs-revascularization-intervention-for-intermittent-leg-claudication-based-on-patient-reported-outcomes
#13
Emily B Devine, Rafael Alfonso-Cristancho, N David Yanez, Todd C Edwards, Donald L Patrick, Cheryl A L Armstrong, Allison Devlin, Rebecca G Symons, Mark H Meissner, Ellen L T Derrick, Danielle C Lavallee, Larry G Kessler, David R Flum
Importance: Intermittent claudication (IC) is the most common presentation of infrainguinal peripheral artery disease. Both medical and revascularization interventions for IC aim to increase walking comfort and distance, but there is inconclusive evidence of the comparative benefit of revascularization given the possible risk of limb loss. Objective: To compare the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for IC in the community, focusing on outcomes of greatest importance to patients...
October 19, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27753733/cauda-equina-conduction-time-determined-by-f-waves-in-normal-subjects-and-patients-with-neurogenic-intermittent-claudication-caused-by-lumbar-spinal-stenosis
#14
Yasuaki Imajo, Tsukasa Kanchiku, Hidenori Suzuki, Masahiro Funaba, Norihiro Nishida, Kazuhiro Fujimoto, Toshihiko Taguchi
INTRODUCTION: Lumbar spinal stenosis (LSS) typically presents with neurogenic intermittent claudication (NIC). The aim is to investigate cauda equina conduction time (CECT) in patients with NIC caused by LSS and its relationship with age and body height in normal subjects. METHODS: The study included 172 normal subjects (mean age 44.1 ± 16.6 years; mean height 163.7 ± 8.9 cm). (Group C) 47 patients (mean age 71.3 ± 8.7 years; mean height 158.8 ± 11.2 cm) underwent surgery due to NIC in cauda equina type for LSS...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27748466/advances-in-exercise-rehabilitation-for-patients-with-lower-extremity-peripheral-artery-disease
#15
Marco Ambrosetti
Patients with Lower Extremity Peripheral Artery Disease (LEPAD) have been recently identified as target groups for structured Cardiac Prevention and Rehabilitation (CPR) programs, whose core components and intervention goals are now well recognized. Historically, exercise training (ET) programs have been employed for the treatment of LEPAD with typical intermittent claudication, and several meta-analysis documented improvements in walking distances of enrolled patients. Both in American and European guidelines, a frequency of at least 3 sessions per week and program duration of 12 weeks were judged as optimal, while recommended sessions lengths were 30-45 minutes and 30-60 minutes respectively...
October 14, 2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/27702407/-diagnostics-and-treatment-of-lower-extremity-peripheral-arterial-disease-guideline-and-registry
#16
A Vahl, B Elsman, A van Enst
- Revision of the 2005 guideline 'Diagnostics and treatment of lower extremity peripheral arterial disease' and the development of an audit have instigated a degree of efficiency and transparency for the treatment of patients with peripheral arterial disease (PAD). - The key recommendations are that first-line treatment of patients, who - preferably by means of a consultation in a vascular laboratory - are diagnosed with intermittent claudication, is supervised exercise therapy and secondary prevention. Referral for second-line treatment only needs to occur when invasive therapy is considered, for example when there is insufficient improvement in symptoms or in patients who have or are developing critical ischemia...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27692118/rehabilitation-therapy-in-peripheral-arterial-disease
#17
Sandeep Aggarwal, Randy D Moore, Ross Arena, Brenda Marra, Amanda McBride, Brea Lamb, Billie-Jean Martin, James Stone
Peripheral arterial disease (PAD) is the result of atherosclerosis in the lower limb arteries, which can give rise to intermittent claudication (IC), limb ulceration, infections, and, in some circumstances, amputation. As a result of PAD, patients are frequently limited in both walking duration and speed. These ambulatory deficits impact both functional capacity and quality of life. The prevalence of PAD is increasing, and patients with this diagnosis have high cardiovascular morbidity and mortality. A comprehensive approach is required to improve outcomes in patients with PAD and include tobacco cessation, pharmacologic management of metabolic fitness, risk-factor modification, and exercise training...
October 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27666444/results-of-common-femoral-artery-thromboendarterectomy-evaluation-of-a-traditional-surgical-management-in-the-endovascular-era
#18
Carola Marie Wieker, Eva Schönefeld, Nani Osada, Christina Lührs, Roland Beneking, Giovanni Torsello, Dittmar Böckler
OBJECTIVE: The aim of this study was to investigate the long-term outcome of common femoral artery thromboendarterectomy in patients with peripheral arterial occlusive disease. METHODS: The study retrospectively evaluated 713 vessels in 655 patients (75% male; mean age, 69.4 ± 9.5 years) who underwent common femoral thromboendarterectomy from January 2006 until May 2012 in two high-volume vascular centers. Critical limb ischemia was present in 221 patients, and intermittent claudication was present in 434...
October 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27638628/non-invasive-management-of-peripheral-arterial-disease
#19
K J Williams, A Babber, R Ravikumar, A H Davies
BACKGROUND: Peripheral arterial disease (PAD) is common and symptoms can be debilitating and lethal. Risk management, exercise, radiological and surgical intervention are all valuable therapies, but morbidity and mortality rates from this disease are increasing. Circulatory enhancement can be achieved using simple medical electronic devices, with claims of minimal adverse side effects. The evidence for these is variable, prompting a review of the available literature. METHODS: Embase and Medline were interrogated for full text articles in humans and written in English...
September 17, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27633168/the-effect-of-supervised-exercise-therapy-for-intermittent-claudication-on-lower-limb-lean-mass
#20
Simon Vui Vun, Michelle D Miller, Christopher L Delaney, Richard B Allan, J Ian Spark
OBJECTIVE: Supervised exercise is currently recommended for the first-line treatment of intermittent claudication based on improvement in walking capacity. However, the promotion of skeletal muscle atrophy by repetitive ischemia-reperfusion caused by treadmill-based programs remains a concern. Because preservation of skeletal muscle mass (SMM) and lean mass (LM) is integral to functional capacity and longevity, this study measured the effect of standard treadmill-based supervised exercise on SMM and regional lower limb LM in patients with intermittent claudication...
September 12, 2016: Journal of Vascular Surgery
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