Chronic lower extremity arterial occlusive diseases

Vrach ◽  
2021 ◽  
Vol 32 (10) ◽  
pp. 28-35
Author(s):  
K. Smirnov ◽  
S. Makarov
Keyword(s):  
Lower Extremity ◽  
Arterial Occlusive Diseases

scholarly journals Treatment of Infrainguinal Arterial Occlusive Disease by Acotec Drug-coated Balloon in 435 Patients

2020 ◽  
Author(s):  
rui ling ◽  
Fengqiang Cui ◽  
Jianghao Chen ◽  
Hui Wang ◽  
Wenlong Shi ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Clinical Data ◽  
Target Lesion ◽  
Major Amputation ◽  
Ischemic Disease ◽  
Late Lumen Loss ◽  
Clinical Events ◽  
Arterial Occlusive Diseases ◽  
Drug Coated Balloon

Abstract Background: At present, there are many clinical trials of drug coated balloon in the treatment of lower extremity arterial occlusive diseases, but there are not many clinical data in the real world study. Here we aimed to evaluate the efficacy and safety ofAcotec drug-coated balloon (DCB) for chronic ischemic disease in lower extremity.Methods: Clinical data of 435 patientswith 564occlusive/stenotic lesions in 492lower extremities treated by DCB from April 2016 toApril2019 were retrospectively analyzed.The mean age was 63years.Rutherford stage 2, 3, 4, 5, and 6 were classified in 11, 167, 182, 109, and 23 limbs, respectively.The mean length of the targeted lesions was 179.6mm. Of all the lesions, 436 located at femoraland/or popliteal arteries, and 128 at infra-popliteal arteries. All the patients were followed up at 6-month intervals. The major evaluation endpoints included late lumen loss (LLL), target lesion restenosis, target lesion revascularization (TLR), and severe clinical events including mortality and major amputation.Results: The technique success rate was 96.1%.Stents were placed in 57 (13.1%) cases for flow-limited dissections or remnant stenosisgreater than 50% after DCB angioplasty.The mean follow-up time was 28.5 ± 12.1 months (12-48 months). The meanLLLwas 1.1 mm, 1.8mm, and 2.8 mm, respectively, 1, 2, and 3 years after operation. The rate ofrestenosis and TLRwas 17.3%and8.2%, respectively, 1 year after operation; 20.6% and 11.6%, respectively, 2 years after operation; 29.4% and 18.3%, respectively, 3 years after operation.Fourteenpatientsdiedand 25received amputation.Conclusion: AcotecDCBwas safe and effective in treating chronic ischemic diseases of lower extremities.A better clinical outcome was achieved in femoro-popliteal arteries, compared toinfrapopliteal arteries.

scholarly journals Assessment of occlusive disease of lower extremity arteries on the basis of anatomic region: Value of 128-slice multidetector CT angiography in comparison with digital subtraction angiography

2017 ◽  
Vol 12 (4) ◽  
pp. 179-186
Author(s):  
Roshan Pangeni ◽  
Ping Han ◽  
Feng Pan ◽  
Laxmi Pangeni Lamsal ◽  
Zhen Zhang ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Lower Extremity ◽  
Digital Subtraction Angiography ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Multidetector Ct ◽  
Digital Subtraction ◽  
Significant Difference ◽  
Arterial Occlusive Diseases ◽  
Sensitivity Specificity

Background & Objectives: The Previous studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems. Our study aimed at assessing the diagnostic value of 128 MDCTA compared with that of digital subtraction angiography (DSA) in the grading of focal arterial disease of lower extremity arteries on the basis of anatomic regions.Materials & Methods: Forty-two patients with peripheral arterial occlusive diseases underwent both MDCTA and DSA. Lower extremity arteries depicted at MDCTA and DSA were graded separately for the degree of stenosis into 3 anatomic regions and 33 segments. Grading by MDCTA and DSA was done independently. Homogeneity analysis was used between MDCTA and DSA measurements in each patient. The sensitivity, specificity, positive predictive value and negative predictive value for detection of stenotic lesions were calculated for all anatomic regions, with findings at DSA used as the reference standard. Results: No statistically significant difference (P>.05) between DSA and MDCTA was present in Aorto-iliac and poplitiofemoral regions while there was statistically significant difference (P<.05) in the infrapopliteal region. The Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value based on a reading of MDCTA were 84.3%, 93.8%, 89.4% and 90.6% for aorto-iliac 86.6%, 94.7%, 84.1% and 94.7% for poplitiofemoral and 95.7%, 86.1%, 85.6% and 95.9% for infra-popliteal region respectively.Conclusion: MDCTA is excellent alternative in diagnosing lower extremity arterial occlusive diseases above the knee. DSA remains better on illustrating distal runoff vessels.

scholarly journals Clinical and morphological features of patients who underwent endovascular interventions for lower extremity arterial occlusive diseases

2015 ◽  
Vol 2 ◽  
pp. 114-118
Author(s):  
Sakir Arslan ◽  
Isa Oner Yuksel ◽  
Erkan Koklu ◽  
Goksel Cagirci ◽  
Cagin Mustafa Ureyen ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Morphological Features ◽  
Endovascular Interventions ◽  
Arterial Occlusive Diseases

Study on Reaction of Subpapillary Venous Plexus in Patients with Arterial Occlusive Diseases of Lower Extremity by Reflective Spectrophotometry

Angiology ◽  
1988 ◽  
Vol 39 (10) ◽  
pp. 858-864
Author(s):  
Tadahiro Kimura ◽  
Nobuko Tsushima ◽  
Satoshi Yoshizaki ◽  
Ryu Nakayama
Keyword(s):  
Lower Extremity ◽  
Venous Plexus ◽  
Arterial Occlusive Diseases

Combining Values

2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Evaluation Method ◽  
Proximal Phalanx ◽  
Common Error ◽  
The Third ◽  
Whole Person ◽  
Impairment Ratings ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.

Quick Reference: Chapter 3: The Musculoskeletal System and Chapter 4: The Nervous System

2000 ◽  
Vol 5 (3) ◽  
pp. 4-4
Keyword(s):  
Nervous System ◽  
Lower Extremity ◽  
Musculoskeletal System ◽  
Multistep Method ◽  
Manual Muscle Testing ◽  
Motor Deficits ◽  
Lower Extremity Weakness ◽  
Residual Symptoms ◽  
Muscle Testing ◽  
Almost All

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, divides PNS deficits into sensory and motor and includes pain in the former. This article, which regards rating sensory and motor deficits of the lower extremities, is continued from the March/April 2000 issue of The Guides Newsletter. Procedures for rating extremity neural deficits are described in Chapter 3, The Musculoskeletal System, section 3.1k for the upper extremity and sections 3.2k and 3.2l for the lower limb. Sensory deficits and dysesthesia are both disorders of sensation, but the former can be interpreted to mean diminished or absent sensation (hypesthesia or anesthesia) Dysesthesia implies abnormal sensation in the absence of a stimulus or unpleasant sensation elicited by normal touch. Sections 3.2k and 3.2d indicate that almost all partial motor loss in the lower extremity can be rated using Table 39. In addition, Section 4.4b and Table 21 indicate the multistep method used for spinal and some additional nerves and be used alternatively to rate lower extremity weakness in general. Partial motor loss in the lower extremity is rated by manual muscle testing, which is described in the AMA Guides in Section 3.2d.

Q&A: Multiple Lower Extremity Impairments and AMA Guides, Third Edition, Revised

2017 ◽  
Vol 22 (2) ◽  
pp. 15-16
Author(s):  
Christopher R. Brigham ◽  
Kathryn Mueller ◽  
Steven Demeter ◽  
Randolph Soo Hoo
Keyword(s):  
Lower Extremity

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

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