scholarly journals Non-Invasive Management of Peripheral Arterial Disease

2016 ◽  
pp. 387-406 ◽  
Author(s):  
K. J. Williams ◽  
A. Babber ◽  
R. Ravikumar ◽  
A. H. Davies
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Non Invasive ◽  
Peripheral Arterial ◽  
Invasive Management

Non-Invasive Management of Peripheral Arterial Disease

2015 ◽  
Author(s):  
K. J. Williams ◽  
A. Babber ◽  
R. Ravikumar ◽  
A. H. Davies
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Non Invasive ◽  
Peripheral Arterial ◽  
Invasive Management

Markers of arterial stiffness in peripheral arterial disease

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 341-348 ◽  
Author(s):  
Marc Husmann ◽  
Vincenzo Jacomella ◽  
Christoph Thalhammer ◽  
Beatrice R. Amann-Vesti
Keyword(s):  
Arterial Stiffness ◽  
Peripheral Arterial Disease ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Arterial Disease ◽  
Care Physician ◽  
Additional Information ◽  
Non Invasive ◽  
Assessment Techniques ◽  
Peripheral Arterial

Abstract. Increased arterial stiffness results from reduced elasticity of the arterial wall and is an independent predictor for cardiovascular risk. The gold standard for assessment of arterial stiffness is the carotid-femoral pulse wave velocity. Other parameters such as central aortic pulse pressure and aortic augmentation index are indirect, surrogate markers of arterial stiffness, but provide additional information on the characteristics of wave reflection. Peripheral arterial disease (PAD) is characterised by its association with systolic hypertension, increased arterial stiffness, disturbed wave reflexion and prognosis depending on ankle-brachial pressure index. This review summarises the physiology of pulse wave propagation and reflection and its changes due to aging and atherosclerosis. We discuss different non-invasive assessment techniques and highlight the importance of the understanding of arterial pulse wave analysis for each vascular specialist and primary care physician alike in the context of PAD.

scholarly journals CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

2021 ◽  
Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ct Perfusion ◽  
Arterial Disease ◽  
Lower Leg ◽  
Therapy Control ◽  
Non Invasive ◽  
Before And After ◽  
Invasive Method ◽  
The Mean ◽  
Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

scholarly journals Molecular Imaging of Lower Extremity Peripheral Arterial Disease: An Emerging Field in Nuclear Medicine

2022 ◽  
Vol 8 ◽  
Author(s):  
Mitchel R. Stacy
Keyword(s):  
Nuclear Medicine ◽  
Molecular Imaging ◽  
Peripheral Arterial Disease ◽  
Lower Extremity ◽  
Lower Extremities ◽  
Arterial Disease ◽  
Diagnostic Tools ◽  
Non Invasive ◽  
Increased Risk ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) is an atherosclerotic disorder of non-coronary arteries that is associated with vascular stenosis and/or occlusion. PAD affecting the lower extremities is characterized by a variety of health-related consequences, including lifestyle-limiting intermittent claudication, ulceration of the limbs and/or feet, increased risk for lower extremity amputation, and increased mortality. The diagnosis of lower extremity PAD is typically established by using non-invasive tests such as the ankle-brachial index, toe-brachial index, duplex ultrasound, and/or angiography imaging studies. While these common diagnostic tools provide hemodynamic and anatomical vascular assessments, the potential for non-invasive physiological assessment of the lower extremities has more recently emerged through the use of magnetic resonance- and nuclear medicine-based approaches, which can provide insight into the functional consequences of PAD-related limb ischemia. This perspectives article specifically highlights and discusses the emerging applications of clinical nuclear medicine techniques for molecular imaging investigations in the setting of lower extremity PAD.

scholarly journals Role of multidetector computed tomography angiography in evaluation of peripheral arterial disease

2020 ◽  
Vol 8 (7) ◽  
pp. 2437
Author(s):  
Rakesh Kumar ◽  
Anil Taneja
Keyword(s):  
Peripheral Arterial Disease ◽  
Color Doppler ◽  
Arterial Disease ◽  
Cross Sectional ◽  
Non Invasive ◽  
Wall Calcification ◽  
Peripheral Arterial ◽  
Infrapopliteal Arteries ◽  
Ct And Mri

Background: Diagnostic imaging plays an important role in the evaluation of peripheral arterial disease. Many imaging modalities are available ranging from conventional modalities to the cross-sectional modalities like Doppler ultrasound, DSA, CT and MRI. The main principles of imaging are to characterize the all lesions detected including type of plaques, no. of lesions, length of stenosis, diameter of vessel in pre-stenotic and post-stenotic segments, degree of wall calcification, assisting in pretreatment planning with respect to route of access, selection of balloon and demonstrates size, extent, neck dimention, and presence of thrombosis in cases with aneurysm.Methods: A Cross-sectional observational study was done in 30 patients. Clinically suspected patients of peripheral arterial disease based on history, sign and symptoms and patients diagnosed with peripheral arterial disease on color doppler were included in our study. Both modalities were compared for detecting the occlusion and stenotic segments.Results: A total of 476 vessel segments were imaged by both modalities. When all arterial segments were considered, MDCTA detected stenosis or occlusion lesions in 30% of arterial segments, versus 18.8% compared to DUS. MDCTA showed 9.8% (95% CI:[4.3%, 15.3%]) more lesions than DUS when all arterial segments were considered together, 11.2% (95% CI: [2.7%, 22.1%]) more lesions when only the iliac arteries were compared, 9.1% (95% CI: [3.2%, 17.2%]) more lesions when only the femoropopliteal arteries were compared, 8.9% (95% CI: [1.5%, 16.3%]) more lesions when only infrapopliteal arteries were compared and 13% (95% CI: [2.6%, 25.4%]) more lesions when only the upper limb arterial segments were compared, (p <0.05 for all comparisons).Conclusions: MDCTA may be used as a screening tool in patients with peripheral arterial disease as it is a non-invasive and more accurate modality when compared to DUS and plays important role in management.

The Correlation between Symptoms and Non-Invasive Test Results in Patients Referred for Peripheral Arterial Disease Testing

1996 ◽  
Vol 1 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Michael H Criqui ◽  
Julie O Denenberg ◽  
Cameron E Bird ◽  
Arnost Fronek ◽  
Melville R Klauber ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Residual Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Leg Pain ◽  
Non Invasive ◽  
Invasive Test ◽  
Peripheral Arterial ◽  
Pain At Rest ◽  
Specific Symptoms

The WHO/Rose questionnaire has served as the epidemiologic and clinical standard in the assessment of leg pain in patients with peripheral arterial disease (PAD) for over three decades. However, the structure of this questionnaire does not allow assessment of leg-specific (i.e. right versus left) symptoms. We studied 508 patients aged 39–95 years (mean 68 years), initially referred for PAD non-invasive testing. A revised questionnaire, the San Diego Claudication Questionnaire, was administered which allowed determination of leg-specific symptoms and evaluated thigh and buttock as well as calf pain. Leg-specific symptoms were categorized into no pain, pain at rest, non-calf claudication, non-Rose calf claudication, and Rose claudication. At the same visit, the ankle brachial index, the toe brachial index, and peak posterior tibial flow velocity were measured by Doppler ultrasound and five categories of non-invasive results by type and severity of PAD were defined. Legs with previous intervention (Rx), surgery or angioplasty, were evaluated separately. Claudication was reported in 42% of no Rx legs and 50% of Rx legs; 40% of claudication was atypical (not Rose); 64% of no Rx and 81% of Rx legs had PAD by non-invasive testing, and 27% of affected legs had severe PAD. The correlation between the severity of symptoms and the severity of ipsilateral PAD in no Rx legs was r=−0.40, p< 0.001. In Rx legs, this correlation was somewhat less ( r=0.27, p< 0.001) due to more symptomatology at lesser degrees of PAD, suggesting reporting bias and/or more residual disease than evident from non-invasive testing. To our knowledge, these results provide the first comparison between a standardized assessment of leg pain and the severity of ipsilateral PAD by non-invasive testing.

scholarly journals Quantitative and qualitative progression of peripheral arterial disease by non-invasive testing

1999 ◽  
Vol 4 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Cameron E Bird ◽  
Michael H Criqui ◽  
Arnost Fronek ◽  
Julie O Denenberg ◽  
Melville R Klauber ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Non Invasive ◽  
Peripheral Arterial

scholarly journals Quantitative optical imaging of vascular response in vivo in a model of peripheral arterial disease

2013 ◽  
Vol 305 (8) ◽  
pp. H1168-H1180 ◽  
Author(s):  
Kristin M. Poole ◽  
Jason M. Tucker-Schwartz ◽  
Wesley W. Sit ◽  
Alex J. Walsh ◽  
Craig L. Duvall ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peripheral Arterial Disease ◽  
Optical Imaging ◽  
Hyperspectral Imaging ◽  
Temporal Dynamics ◽  
Arterial Disease ◽  
Sensor Data ◽  
Morphological Data ◽  
Non Invasive ◽  
Peripheral Arterial

The mouse hind limb ischemia (HLI) model is well established for studying collateral vessel formation and testing therapies for peripheral arterial disease, but there is a lack of quantitative techniques for intravitally analyzing blood vessel structure and function. To address this need, non-invasive, quantitative optical imaging techniques were developed to assess the time-course of recovery in the mouse HLI model. Hyperspectral imaging and optical coherence tomography (OCT) were used to non-invasively image hemoglobin oxygen saturation and microvessel morphology plus blood flow, respectively, in the anesthetized mouse after induction of HLI. Hyperspectral imaging detected significant increases in hemoglobin saturation in the ischemic paw as early as 3 days after femoral artery ligation ( P < 0.01), and significant increases in distal blood flow were first detected with OCT 14 days postsurgery ( P < 0.01). Intravital OCT images of the adductor muscle vasculature revealed corkscrew collateral vessels characteristic of the arteriogenic response to HLI. The hyperspectral imaging and OCT data significantly correlated with each other and with laser Doppler perfusion imaging (LDPI) and tissue oxygenation sensor data ( P < 0.01). However, OCT measurements acquired depth-resolved information and revealed more sustained flow deficits following surgery that may be masked by more superficial measurements (LDPI, hyperspectral imaging). Therefore, intravital OCT may provide a robust biomarker for the late stages of ischemic limb recovery. This work validates non-invasive acquisition of both functional and morphological data with hyperspectral imaging and OCT. Together, these techniques provide cardiovascular researchers an unprecedented and comprehensive view of the temporal dynamics of HLI recovery in living mice.

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