Atherosclerotic occlusive arterial disease of the lower limbs: a historical account of surgical evolution and vascular reconstruction over thirty four years

Ratnatunga, P.C.A.; Gunawardene, R.; Pinto, Vasanthi; Perera, Ruwan; Amerasinghe, Priyanie H.; Hewavithana, P. B.; Rosairo, Shanthini; Ratnatunga, Neelakanthi

doi:10.4038/sljs.v36i2.8508

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…22,23 After diabetes, hypertension has played a major role in PAD (OR, 1.99; 95% CI, 1.55-2.62; p < 0.05) with a frequency that also exceeds 80%, and more proximal patterns of involvement have been described than the rest of cardiovascular factors, except for smoking. 15,20,24 Various studies indicate that aortoiliac involvement (RR, 1.17; 95% CI, 1.99-1.39; p < 0.05) exceeds the IP (RR, 1.06; 95% CI, 0.92-1.22; p < 0.05) and FP (RR, 1.0; 95% CI, 0.98-1.23; p < 0.05); 3 this fact shares similarities with our findings in the aortoiliac sector with long, complex, and chronic occlusive lesions mostly compatible with a TASC-II D (p = 0.053).…”

Section: Discussionmentioning

confidence: 99%

Arteriographic patterns of peripheral arterial disease in lower limbs in a Peruvian cohort of patients

et al. 2022

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Introduction There is currently no universal and uniform pattern of peripheral arterial disease (PAD) in the lower limbs; however, it is influenced by various cardiovascular factors of the individual. The objective of this study was to identify the arteriographic patterns of PAD in the lower limbs according to cardiovascular factors in a Peruvian cohort of patients. Methods This is an analytical, observational, and retrospective study. The arteriographic patterns of PAD in the aortoiliac segment were analyzed with the TransAtlantic InterSociety Consensus (TASC-II) score and the Global Anatomic Staging System (GLASS) for the femoropopliteal (FP), infraopopliteal (IP), and pedial (P) segments in a Peruvian cohort from January 2018 to May 2021. Results 595 patients (833 extremities) were analyzed with a mean age of 67.54 ± 16.39 years, and the main cardiovascular factor was diabetes (65.04%). The patients older than 65 years with GLASS FP 4 (p = 0.042), IP 0 (p = 0.004), and P2 ( p = 0.047) presented significant findings: in men and women with GLASS IP 4 ( p = 0.031) and P 2 ( p = 0.045); diabetes with TASC-II A ( p = 0.031), GLASS FP 4 ( p = 0.038), IP 4 ( p = 0.009), and P2 ( p = 0.003); dyslipidemia with TASC-II D ( p = 0.027), GLASS FP 4 ( p = 0.038), IP 0 ( p = 0.009), and P0 ( p = 0.003); smoking with TASC-II D ( p = 0.001), GLASS FP 4 ( p = 0.049) and IP 0 ( p = 0.008); chronic coronary disease with GLASS IP 4 ( p = 0.049) and P2 ( p = 0.037); chronic kidney disease with GLASS FP 4 ( p=0.047), IP 4 ( p = 0.004), and P2 ( p = 0.016); and previous amputation history with GLASS IP 4 ( p = 0.015) and P2 ( p = 0.039). The most frequent arteriographic pattern of PAD in the lower limbs of our cohort was TASC-II A, GLASS FP 0 and 4, IP 0, and P2 ( p = 0.047). Conclusion Our work will allow the limb salvage teams to understand the behavior of PAD affectation in the population of our environment, allowing a timely control of cardiovascular risk factors, adequate revascularization planning, and a significant reduction in the risk of loss of limb.

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Section: Discussionmentioning

confidence: 99%

Arteriographic patterns of peripheral arterial disease in lower limbs in a Peruvian cohort of patients

et al. 2022

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“…Patients with PAD have high prevalence of metabolic syndrome (MS), and in individuals in whom both diseases coexist, a higher prevalence of the main classic cardiovascular risk factors is observed, such as kidney failure, coronary heart disease, and cerebrovascular disease 12 , 53 , 54 .…”

Section: Definition and Measurement Of Abimentioning

confidence: 99%

Ankle-brachial index: more than a diagnostic test?

Cáceres-Farfán

Moreno-Loaiza

Cubas

2021

Arch Peru Cardiol Cir Cardiovasc

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The ankle-brachial index (ABI) is the relationship between the systolic blood pressure taken at the ankle level and the brachial artery. A pathological ABI (<0.90 or >1.40) indicates the presence of peripheral artery disease (PAD). Many studies indicate the great utility of this test in the diagnosis of PAD due to its ease of use, reproducibility, low cost, and high cost-effectiveness. This evaluation can be directly correlated with cardiovascular morbidity and mortality; however, it has recently been confirmed that a low ABI can be a predictor of major cardiovascular events, as it is related to diabetes mellitus, chronic coronary disease, stroke, and more. The objective of this work was to review the current evidence on the importance of ABI in the diagnosis of PAD and its main role as a predictor of cardiovascular morbidity and mortality.

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Atherosclerotic occlusive arterial disease of the lower limbs: a historical account of surgical evolution and vascular reconstruction over thirty four years

Cited by 2 publications

References 5 publications

Arteriographic patterns of peripheral arterial disease in lower limbs in a Peruvian cohort of patients

Arteriographic patterns of peripheral arterial disease in lower limbs in a Peruvian cohort of patients

Ankle-brachial index: more than a diagnostic test?

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