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Intermittent claudication

Anna Maria Fratta Pasini, Chiara Stranieri, Anna Maria Rigoni, Sergio De Marchi, Denise Peserico, Chiara Mozzini, Luciano Cominacini, Ulisse Garbin
AIM: Ischemia-reperfusion (I-R) produces reactive oxygen species (ROS) that damage cells and favour cytotoxicity and apoptosis in peripheral artery disease (PAD) patients. Since brief episodes of I-R (ischemic conditioning) protect cells against ischemic harms, we evaluated whether a short-course of supervised treadmill training, characterized by repeated episodes of I-R, makes peripheral blood mononuclear cells (PBMCs) from PAD patients with intermittent claudication more resistant to I-R injuries by reducing oxidative stress and by inducing an adaptative response of unfolded protein response (UPR) and nuclear factor-E2-related factor (Nrf2) pathway expression...
March 13, 2018: Journal of Atherosclerosis and Thrombosis
Gerry Fowkes, Ian N Gillespie
BACKGROUND: Intermittent claudication is pain in the legs due to muscle ischaemia associated with arterial stenosis or occlusion. Angioplasty is a technique that involves dilatation and recanalisation of a stenosed or occluded artery. OBJECTIVES: The objective of this review was to determine the effects of angioplasty of arteries in the leg when compared with non surgical therapy, or no therapy, for people with mild to moderate intermittent claudication. SEARCH METHODS: Sources searched include the Cochrane Peripheral Vascular Diseases Group's Specialized Trials Register (August 2006), the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2006) and reference lists of relevant articles...
March 9, 2018: Cochrane Database of Systematic Reviews
Hans I V Lindgren, Peter Qvarfordt, Stefan Bergman, Anders Gottsäter
BACKGROUND: Intermittent claudication (IC) is commonly caused by lesions in the superficial femoral artery (SFA), yet invasive treatment is still controversial and longer term patient-reported outcomes are lacking. This prospective randomized trial assessed the 24-month impact of primary stenting with nitinol self-expanding stents compared to best medical treatment (BMT) alone in patients with stable IC due to SFA disease on health-related quality of life (HRQoL). METHODS: One hundred patients with stable IC due to SFA disease treated with BMT were randomized to either stent (n = 48) or control (n = 52) group...
March 8, 2018: Cardiovascular and Interventional Radiology
Farzin Fakhry, Hugo Jp Fokkenrood, Sandra Spronk, Joep Aw Teijink, Ellen V Rouwet, M G Myriam Hunink
BACKGROUND: Intermittent claudication (IC) is the classic symptomatic form of peripheral arterial disease affecting an estimated 4.5% of the general population aged 40 years and older. Patients with IC experience limitations in their ambulatory function resulting in functional disability and impaired quality of life (QoL). Endovascular revascularisation has been proposed as an effective treatment for patients with IC and is increasingly performed. OBJECTIVES: The main objective of this systematic review is to summarise the (added) effects of endovascular revascularisation on functional performance and QoL in the management of IC...
March 8, 2018: Cochrane Database of Systematic Reviews
Sean C Maguire, Christina A Fleming, Gavin O'Brien, Gerald McGreal
BACKGROUND: Lumbar sympthectomy (LS) was traditionally performed for intermittent claudication but is now eclipsed by revascularisation for that indication. However, it retains a role in the management of critical limb ischaemia and other conditions causing lower limb pain with or without ischaemia. We report the role of LS in modern surgical practice when revascularisation and pain management options have been exhausted. METHODS: A medical chart review was performed on all patients who underwent LS in our unit from 2005 to 2016 (inclusive)...
March 7, 2018: Irish Journal of Medical Science
Muzaffer Kahyaoğlu, Mustafa Ağca, Ender Özgün Çakmak, Çetin Geçmen, İbrahim Akın İzgi
Contrast-induced encephalopathy (CIE) is a rare complication of angiography. Presently reported is the case of a patient diagnosed with CIE following peripheral angioplasty with the non-ionic contrast agent, iohexol. A 66-year-old male patient described intermittent claudication and peripheral arterial disease was suspected. Lower extremity angiography was performed, and following dilation of a 7.0x150-mm balloon, a 9.0x57-mm stent was placed in the lesioned vessel. The patient subsequently developed confusion and cortical blindness, and a seizure occurred 1 hour after the procedure...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Corey A Kalbaugh, Nicole Jadue Gonzalez, Daniel J Luckett, Jason Fine, Thomas E Brothers, Mark A Farber, Adam W Beck, John W Hallett, William A Marston, Raghuveer Vallabhaneni
OBJECTIVE: Although smoking cessation is a benchmark of medical management of intermittent claudication, many patients require further revascularization. Currently, revascularization among smokers is a controversial topic, and practice patterns differ institutionally, regionally, and nationally. Patients who smoke at the time of revascularization are thought to have a poor prognosis, but data on this topic are limited. The purpose of this study was to evaluate the impact of smoking on outcomes after infrainguinal bypass for claudication...
March 2, 2018: Journal of Vascular Surgery
Samuel Fernández, Juan Carlos Parodi, Fabián Moscovich, Camilo Pulmari
BACKGROUND: Medical treatment of disabling intermittent claudication or critical limb threatening ischemia causing rest pain often fails or has partial response. METHODS: In this pilot study thirty-six patients (12 females) affected by disabling intermittent claudication or rest pain of the lower extremities were exposed to a daily 3 L water intake for up to six weeks. Cutaneous foot temperature, ankle/brachial index, time and distance of claudication and pain intensity were recorded before and at the completion of the hydration period...
February 23, 2018: Annals of Vascular Surgery
Fredrik Sartipy, Birgitta Sigvant, Fredrik Lundin, Eric Wahlberg
OBJECTIVE: The aim was to determine long-term mortality rates and the underlying cause of death for subjects with different peripheral arterial disease (PAD) stages in a population based setting. METHODS: A randomly selected population sample of 5080 subjects was enrolled in the study in 2004-2005. Participants completed health state questionnaires and underwent ankle brachial index (ABI) measurements for classification into PAD severity stages and reference subjects...
February 22, 2018: European Journal of Vascular and Endovascular Surgery
Melinda S Schaller, Joel L Ramirez, Warren J Gasper, Greg J Zahner, Nancy K Hills, S Marlene Grenon
OBJECTIVE: Frailty, a syndrome characterized by decreased physiologic reserves and resistance to stressors, is associated with disability, poor surgical outcomes, and mortality. We evaluated the impact of frailty on cardiovascular disease (CVD) events in peripheral arterial disease (PAD) patients with intermittent claudication. METHODS: We conducted a retrospective review of patients with stable intermittent claudication enrolled in the OMEGA-PAD Study between 2010-2015...
February 22, 2018: Annals of Vascular Surgery
Nicola Lamberti, Sofia Straudi, Efisio Lissia, Lorenza Cavazzini, Sergio Buja, Roberto Manfredini, Nino Basaglia, Fabio Manfredini
BACKGROUND: Peripheral arterial disease (PAD) is a common cardiovascular pathology affecting mobility in elderly. Osteoarticular diseases (ODs), responsible for functional limitations and confounding leg symptoms, may interfere with exercise therapy. This study evaluates the feasibility and effectiveness of a structured home-based exercise programme on rehabilitative outcomes in a cohort of elderly PAD patients with and without coexisting ODs. PATIENTS AND METHODS: Patients were enrolled from 2002 to 2016 in an exercise programme prescribed and controlled at the hospital and based on two daily 10-minute home walking sessions below the self-selected speed...
February 21, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Maria Szymczak, Paweł Krupa, Grzegorz Oszkinis, Marian Majchrzycki
BACKGROUND: The aim of the present paper is to assess the gait pattern of patients with Peripheral Artery Disease (PAD). A more specific aim is to compare the gait pattern of PAD patients before and after the appearance of intermittent claudication symptoms. METHODS: The study involved 34 PAD patients with a claudication distance ≥200 m and 20 participants without PAD, who formed the control group. The gait pattern of PAD patients was assessed twice: before the appearance of intermittent claudication symptoms (pain-free conditions) and after the appearance of intermittent claudication symptoms (pain conditions)...
February 20, 2018: BMC Geriatrics
Victor Aboyans, Marie-Antoinette Sevestre, Ileana Désormais, Philippe Lacroix, Gerry Fowkes, Michael H Criqui
It is estimated that more than 200 million individuals are affected by lower extremity artery disease (LEAD) worldwide. This prevalence has increased between 2000 and 2010 by 25%, especially in low/middle income countries. In France, about one million people are affected by this condition. Almost two-thirds of patients with LEAD are asymptomatic. This explains the interest of the measurement of the ankle-brachial index (ABI), an objective and harmless diagnostic tool. An ABI≤0.90 is considered as diagnostic for LEAD...
February 12, 2018: La Presse Médicale
Sunil R Iyer, Brian H Annex
Peripheral arterial disease (PAD) is a major health care problem. There have been limited advances in medical therapies, and a huge burden of symptomatic patients with intermittent claudication and critical limb ischemia who have limited treatment options. Angiogenesis is the growth and proliferation of blood vessels from existing vasculature. For approximately 2 decades, "therapeutic angiogenesis" has been studied as an investigational approach to treat patients with symptomatic PAD. Despite literally hundreds of positive preclinical studies, results from human clinical studies thus far have been disappointing...
October 2017: JACC. Basic to Translational Science
Damien Garrigues, Béatrice Ferrari, Nicole Petrissans Ferrando, Thibaut Guiraut
WHAT WE KNEW: The vascular rehabilitation is an effective treatment for patients with an intermittent claudication linked to lower-extremity artery disease. This treatment increases the claudication distance of 180% with the Gardner's protocol (30 to 60 minutes of walking at least 3 times a week, walking until appearance of a mild pain) and allows also to control the vascular risk factors. This treatment is not enough prescribed for many reasons and often requires a hospitalization in a rehabilitation centre...
January 26, 2018: La Presse Médicale
Lawrence Oresanya, Michael Mazzei, Riyaz Bashir, Aisha Farooqui, Ganesh Athappan, Stephanie Roth, Eric T Choi, Paul van Bemmelen
BACKGROUND: High-pressure intermittent limb compression (HPILC) has been proposed as an alternative treatment of disabling intermittent claudication. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of HPILC in improving walking distance in patients with intermittent claudication. METHODS: A search through December 31, 2016, was performed to identify all randomized controlled trials evaluating the efficacy of HPILC for the management of intermittent claudication...
February 2018: Journal of Vascular Surgery
Birnur Yilmaz
OBJECTIVE: To investigate the value of Acoustic Radiation Force Impulse elastography and its application in Achilles tendon elasticity of intermittent claudication due to lower extremity arterial ischaemia. METHODS: This prospective case-control study was conducted at the Department of Radiology, Faculty of Medicine, Baskent University, Istanbul, Turkey, from October 2015 to January 2016, and comprised bilateral Achilles tendons of patients with intermittent claudication and healthy individuals...
January 2018: JPMA. the Journal of the Pakistan Medical Association
Markos Klonizakis, Stephen M Bianchi, Marie Gernigon, Pierre Abraham, Shah Nawaz
OBJECTIVE: Lower extremity peripheral arterial disease (PAD) is a chronic condition most commonly presenting with intermittent claudication (IC). Intermittent claudication limits walking ability and may negatively affect health-related quality of life. Treadmill assessment of maximal walking distance (MWD) is the gold standard to assess PAD symptom severity. Despite being a well-established and reproducible tool, it may be inappropriate (due to frailty or fear) for some patients and only describes maximal abilities for a single walk test...
January 24, 2018: Clinical Physiology and Functional Imaging
Marcus Thieme, Michael Lichtenberg, Marianne Brodmann, Angelo Cioppa, Dierk Scheinert
BACKGROUND: Most common clinical presentation of peripheral artery disease (PAD) comprises intermittent claudication (IC), but about one third of patients will progress to critical limb ischemia (CLI), characterized by rest pain and/or tissue loss, which is the most severe limb manifestation of PAD. Paclitaxel-coated balloons are well established for the endovascular treatment of femoropopliteal lesions in patients with IC and CLI. This ongoing multicenter registry study is exploring the role of the Lutonix® 014 drug- coated balloon (DCB) in the treatment of below-the-knee (BTK) arteries and CLI...
January 23, 2018: Journal of Cardiovascular Surgery
Patrick Fransen
Background: Neurogenic intermittent claudication (NIC) is the main symptom of degenerative lumbar spinal stenosis. Percutaneous interspinous process decompression devices (IPDs) have been designed as an alternative therapy to conservative treatment and to open decompressive surgery for patients suffering from NIC. Initial short-term results were encouraging. We present the long-term results of a group of patients that we followed to provide insight on long-term outcomes and effectiveness of this technique compared to other decompression methods...
December 2017: Journal of Spine Surgery (Hong Kong)
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