Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3944_Библиотеки_им_академика_М_И_Перельмана
.pdf
1 Epidemiology ofPeripheral Artery Disease
28
29 Eraso LH, Fukaya E, Mohler ER 3rd, etal. Peripheral arterial disease,
prevalence and cumulative risk factor profile analysis. Eur J Prev Cardiol.
2014; 21(6): 704–11.
30 Kannel WB, Skinner JJ Jr, Schwartz MJ, etal. Intermittent claudication:
incidence in the Framingham Study. Circulation. 1970; 41: 875–83.
31 Hooi JD, Kester ADM, Stoffers HEJH, etal. Incidence of and risk factors for
asymptomatic peripheral arterial occlusive disease: a longitudinal study. Am J
Epidemiol. 2001; 153: 666–72.
32 Kennedy M, Solomon C, Manolio TA, etal. Risk factors for declining ankle‐
brachial index in men and women 65 years or older: the Cardiovascular
Health Study. Arch Intern Med. 2005; 165: 1896–902.
33 Ingolfsson IO, Sigurdsson G, Sigvaldason H, etal. A marked decline in the
prevalence and incidence of intermittent claudication in Icelandic men
1968–1986: a strong relationship to smoking and serum cholesterol–the
Reykjavik Study. J Clin Epidemiol. 1994; 47: 1237–43.
34 Bowlin SJ, Medalie JH, Flocke SA, etal. Epidemiology of intermittent
claudication in middle‐aged men. Am J Epidemiol. 1994; 140: 418–30.
35 Kannel WB, McGee DL. Update on some epidemiological features of
intermittent claudication: the Framingham study. J Am Geriatr Soc. 1985; 22:
13–18.
36 Leng GC, Fowkes FG. The Edinburgh claudication questionnaire: An
improved version of the WHO/Rose questionnaire for use in epidemiological
surveys. J Clin Epidemiol. 1992; 45(10): 1101–9.
37 Nehler MR, Duval S, Diao L, etal. Epidemiology of peripheral arterial disease
and critical limb ischemia in an insured national population. J Vasc Surg. 2014;
60: 686–95.
38 McDermott MM, Liu K, Criqui MH, etal. Ankle‐brachial index and
subclinical cardiac and carotid disease: the multi‐ethnic study of
atherosclerosis. Am J Epidemiol. 2005; 162: 33–41.
39 McDermott MM, Greenland P, Liu K, etal. Leg symptoms in peripheral
arterial disease: associated clinical characteristics and functional impairment.
JAMA. 2001; 286: 1599–1606.
40 Hirsch AT, Allison MA, Gomes AS, etal. American Heart Association
Council on Peripheral Vascular Disease; Council on Cardiovascular Nursing;
Council on Cardiovascular Radiology and Intervention; Council on
Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology;
Council on Epidemiology and Prevention. A call to action: women and
peripheral artery disease: a scientific statement from the American Heart
Association. Circulation. 2012; 125(11): 1449–72.
41 Schroll M, Munck O. Estimation of peripheral arteriosclerotic disease by ankle
blood pressure measurements in a population study of 60‐year‐old men and
women. J Chronic Dis. 1981; 34(6): 261–9.
https://t.me/med1917
References 29
42 Newman AB, Sutton‐Tyrrell K, Vogt MT, Kuller LH. Morbidity and mortality
in hypertensive adults with a low ankle/arm blood pressure index. JAMA.
1993; 270: 487–489.
43 Zheng ZJ, Sharrett AR, Chambless LE, etal. Associations of ankle–brachial
index with clinical coronary heart disease, stroke and preclinical carotid and
popliteal atherosclerosis: the Atherosclerosis Riskhin Communities (ARIC)
study. Atherosclerosis. 1997; 131: 115–25.
44 Meijer WT, Hoes AW, Rutgers D, etal. Peripheral arterial disease in the
elderly: the Rotterdam Study. Arterioscler Thromb Vasc Biol 1998; 18: 185–92.
45 Cimminiello C. PAD: Epidemiology and pathophysiology. Thromb Res. 2002;
106(6): V295–V301.
46 Halperin JL. Evaluation of patients with peripheral vascular disease. Thromb
Res. 2002; 106: V303–V311.
47 Fowkes FG. The measurement of atherosclerotic peripheral arterial disease in
epidemiological surveys. Int J Epidemiol. 1988; 17: 248–54.
48 Lijmer JG, Hunink MG, van den Dungen JJ, etal. ROC analysis of noninvasive
tests for peripheral arterial disease. Ultrasound Med Biol. 1996; 22: 391–8.
49 Baker JD, Dix DE. Variability of Doppler ankle pressures with arterial
occlusive disease: an evaluation of ankle index and brachial‐ankle pressure
gradient. Surgery. 1981; 89: 134–7.
50 Yao ST. Haemodynamic studies in peripheral arterial disease. Br J Surg. 1970;
57: 761–6.
51 Stoffers HE, Rinkens PE, Kester AD, etal. The prevalence of asymptomatic
and unrecognized peripheral arterial occlusive disease. Int J Epidemiol. 1996;
25: 282–90.
52 Rose GA. The diagnosis of ischaemic heart pain and intermittent claudication
in field surveys. Bull World Health Organ. 1962; 27: 645–58.
53 Newman AB, Siscovick DS, Manolio TA, etal. Ankle‐arm index as a marker of
atherosclerosis in the Cardiovascular Health Study.Circulation. 1993; 88:
837–45.
54 McDermott MM, Ferrucci L, Simonsick EM, etal. The ankle brachial index
and change in lower extremity functioning over time: the Women’s Health and
Aging Study. J Am Geriatr Soc. 2002; 50: 238–46.
55 Cammer‐Paris BE, Libow LS, Halperin JL, Mulvihill MN. The prevalence and
one‐year outcome of limb arterial obstructive disease in a nursing home
population. J Am Geriatr Soc. 1988; 36: 607–612.
56 Newman AB, Naydeck BL, Sutton‐Tyrrell K, etal. The role of comorbidity in
the assessment of intermittent claudication in older adults. J Clin Epidemiol.
2001; 54(3): 294–300.
57 Criqui MH, Denenberg JO, Bird CE, etal. The correlation between symptoms
and non‐invasive test results in patients referred for peripheral arterial disease
testing. Vasc Med. 1996; 1: 65–71.
https://t.me/med1917
1 Epidemiology ofPeripheral Artery Disease
30
58 A Reunanen, H Takkunen, A Aromaa. Prevalence of intermittent claudication
and its effect on mortality. Acta Med Scand. 1982: 44: 249–256.
59 Smith GD, Shipley MJ, Rose G. Intermittent claudication, heart disease risk
factors, and mortality. The Whitehall Study. Circulation. 1990; 82: 1925–31.
60 Diehm C, Schuster A, Allenberg JR, etal. High prevalence of peripheral
arterial disease and co‐morbidity in 6880 primary care patients: cross‐
sectional study. Atherosclerosis. 2004; 172(1): 95–105.
61 Ness J, Aronow WS, Ahn C. Risk factors for peripheral arterial disease in an
academic hospital‐based geriatrics practice. J Am Geriatr Soc. 2000; 48: 312–14.
62 Jensen SA, Vatten LJ, Myhre HO. The prevalence of chronic critical lower limb
ischaemia in a population of 20, 000 subjects 40–69 years of age. Eur J Vasc
Endovasc Surg. 2006; 32(1): 60–5.
63 Creager MA, Kaufman JA, Conte MS. Acute limb ischaemia. N Engl J Med.
2012; 366: 2198–206.
64 Campbell WB, Ridler BMF, Szymanska TH. Current management of acute leg
ischaemia: results of an audit by the Vascular Surgical Society of Great Britain
and Ireland. Br J Surg. 1998; 85: 1498–503.
65 Dormandy J, Heeck L, Vig S. Acute limb ischemia”. Semin Vasc Surg. 1999;
12(2): 148–53.
66 Henke P. Contemporary management of acute limb ischaemia: factors
associated with amputation and in‐hospital mortality. Semin Vasc Surg. 2009;
22: 34–40.
67 Brearly S. Acute leg ischaemia. BMJ. 2013; 346: f2681.
68 Criqui MH, Aboyans B. Circ Res. 2015; 116: 1509–26.
69 WG Hughson, JI Mann, A Garrod. Intermittent claudication: prevalence and
risk factors. Br Med J. 1978; 1: 1379–81.
70 Celermajer DS, Sorensen KE, Georgakopoulos D, etal. Cigarette smoking and
associated with dose‐related and potentially reversible impairment of
endothelium‐dependent dilation in healthy young adults. Circulation. 1993;
88: 2149–55.
71 Price JF, Mowbray PI, Lee AJ, etal. Relationship between smoking and
cardiovascular risk factors in the development of peripheral arterial disease
and coronary artery disease: Edinburgh Artery Study. Eur Heart J. 1999; 20:
344–53.
72 Fowkes FG, Housley E, Riemersma RA, etal. Smoking, lipids, glucose
intolerance and blood pressure as risk factor for peripheral atherosclerosis
compared with ischemic heart disease in the Edinburgh Artery Study. Am J
Epidemiol. 1992; 135: 331–40.
73 WB Kannel, D Shurleff. The Framingham Study. Cigarettes and the
development of intermittent claudication. Geriatrics. 1973; 28: 61–8.
74 He Y, Lam TH, Jiang B, etal.Passive smoking and risk of peripheral arterial
disease and ischemic stroke in Chinese women who never smoked.
Circulation. 2008; 118: 1535–40.
https://t.me/med1917
References 31
75 Faulkner KW, House AK, Castleden WM. The effect of cessation of smoking
on the accumulative survival rates of patients with symptomatic peripheral
vascular disease. Med J Aust. 1983; 1: 217–9.
76 Jonason T, Bergström R. Cessation of smoking in patients with intermittent
claudication. Effects on the risk of peripheral vascular complications,
myocardial infarction and mortality. Acta Med Scand. 1987; 221: 253–60.
77 Brand FN, Abbott RD, Kannel WB. Diabetes, intermittent claudication and
risk of cardiovascular events. The Framingham Study. Diabetes. 1989; 38:
504–9.
78 J Dormandy, L Heeck, S Vig. Predicting which patients will develop chronic
critical leg ischemia. Semin Vasc Surg. 1999; 12: 138–41.
79 Criqui MH, Browner D, Fronek A, etal. Peripheral arterial disease in large
vessels is epidemiologically distinct from small vessel disease: an analysis of
risk factors. Am J Epidemiol. 1989; 129: 1110–19.
80 Price JF, Lee AJ, Fowkes FG. Hyperinsulinemia: a risk factor for peripheral
arterial disease in a non diabetic general population. J Cardiovasc Risk. 1996;
3: 501–5.
81 Joosten MM, Pai JK, Bertoia ML, etal. Associations between conventional
cardiovascular risk factors and risk of peripheral artery disease in men. JAMA.
2012; 308: 1660–7.
82 Beks PJ, Mackaay AJ, de Neeling JN, etal. Peripheral arterial disease in
relation to glycaemic level in an elderly Caucasian population: the Hoorn
study. Diabetologia. 1995; 38: 86–96.
83 Most RS, Sinnock P. The epidemiology of lower extremity amputations in
diabetic individuals. Diabetes Care. 1983; 6: 87–91.
84 Jude EB, Oyibo SO, Chalmers N, Boulton AJ. Peripheral arterial disease in
diabetic and nondiabetic patients: a comparison of severity and outcome.
Diabetes Care. 2001; 24: 1433–7.
85 Zimmerman BR, Palumbo PJ, Fallon WM, etal. A prospective study of
peripheral occlusive arterial disease in diabetes: III. Initial lipid and
lipoprotein findings. Mayo Clinic Proc. 1981; 56: 233–42.
86 Curb JD, Masaki K, Rodriguez BL, etal. Peripheral artery disease and
cardiovascular risk factors in the elderly. The Honolulu Heart Program.
Arterioscler Thromb Vasc Biol. 1996; 16: 1495–1500.
87 Boers GHJ, Smals AGH, Trijbels FJM, etal. Heterozygosity for
homocystinuria in premature peripheral and cerebral occlusive arterial
disease. N Engl J Med. 1985; 313: 709–15.
88 Malinow MR, Kang SS, Taylor IM, etal. Prevalence of hyperhomocyst(e)
inemia in patients with peripheral arterial occlusive disease. Circulation. 1989;
79: 1180–8.
89 Aronow WS, Ahn C. Association between plasma homocysteine and
peripheral arterial disease in older persons. Coronary Artery Dis. 1998; 9:
49–50.
https://t.me/med1917
1 Epidemiology ofPeripheral Artery Disease
32
90 Boushey CJ, Beresford SA, Omenn GS, Motulsky AG. A quantitative
assessment of plasma homocysteine as a risk factor for vascular disease.
Probable benefits of increasing folic acid intakes. JAMA. 1995; 274: 1049–57.
91 Khandanpour N, Loke YK, Meyer FJ, etal. Homocysteine and peripheral
arterial disease: systematic review and meta‐analysis. Eur J Vasc Endovasc
Surg. 2009; 38: 316–22.
92 Robinson K, Arheart K, Refsum H, etal. Low circulating folate and vitamin
B6 concentrations: risk factors for stroke, peripheral vascular disease, and
coronary artery disease. European COMAC Group. Circulation. 1998; 97:
437–43. (Erratum in: Circulation 1999; 99: 983.)
93 Taylor LM Jr, DeFrang RD, Harris EJ Jr, etal. The association of elevated
plasma homocyst(e)ine with progression of symptomatic peripheral arterial
disease. J Vasc Surg. 1991; 13: 128–36.
94 Molgaard J, Malinow MR, Lassvik C, etal. Hyperhomocyst(e)inaemia: an
independent risk factor for intermittent claudication. J Intern Med. 1992;
231: 273–9.
95 Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic
atherosclerosis: a comparison of C‐reactive protein, fibrinogen,
homocysteine, lipoprotein(a), and standard cholesterol screening as
predictors of peripheral arterial disease. JAMA. 2001; 285: 2481–5.
96 Bloemenkamp DG, van den Bosch MA, Mali WP, etal. Novel risk factors
forperipheral arterial disease in young women. Am J Med. 2002; 113:
462–467.
97 Allison MA, Criqui MH, McClelland RL, etal. The effect of novel
cardiovascular risk factors on the ethnic‐specific odds for peripheral arterial
disease in the Multi‐Ethnic Study of Atherosclerosis (MESA). J Am Coll
Cardiol. 2006; 48: 1190–7.
98 Poirier P, Giles TD, Bray GA, etal. Obesity and cardiovascular disease:
pathophysiology, evaluation, and effect of weight loss: an update of the 1997
American Heart Association Scientific Statement on Obesity and Heart
Disease from the Obesity Committee of the Council on Nutrition, Physical
Activity, and Metabolism. Circulation. 2006; 113: 898–918.
99 Kyle UG, Genton L, Hans D, etal. Total body mass, fat mass, fat‐free mass,
and skeletal muscle in older people: cross‐sectional differences in 60‐year‐old
persons. J Am Geriatr Soc. 2001; 49: 1633–1640.
100 Douketis JD, Sharma AM. Obesity and cardiovascular disease: pathogenic
mechanisms and potential benefits of weight reduction. Semin Vasc Med.
2005; 5: 25–33.
101 Ix JH, Biggs ML, Kizer JR, Mukamal KJ, Djousse L, etal. Association of body
mass index with peripheral arterial disease in older adults: the
Cardiovascular Health Study. Am J Epidemiol. 2011; 174: 1036–43.
102 Lu B, Zhou J, Waring ME, Parker DR, Eaton CB. Abdominal obesity and
peripheral vascular disease in men and women: a comparison of
https://t.me/med1917
References 33
waist‐to‐thigh ratio and waist circumference as measures of abdominal
obesity. Atherosclerosis. 2010; 208: 253–7.
103 Vogt MT, Cauley JA, Kuller LH, Hulley SB. Prevalence and correlates of
lower extremity arterial disease in elderly women. Am J Epidemiol. 1993; 137:
559–68.
104 Katsilambros NL, Tsapogas PC, Arvanitis MP, etal. Risk factors for lower
extremity arterial disease in non‐insulin‐dependent diabetic persons. Diabet
Med. 1996; 13: 243–2.
105 Mya MM, Aronow WS. Increased prevalence of peripheral arterial disease in
older men and women with subclinical hypothyroidism. J Gerontol A Biol Sci
Med Sci. 2003; 58A: M68–9.
106 Fabsitz RR, Sidawy AN, Go O, etal. Prevalence of peripheral arterial disease
and associated risk factors in American Indians: the Strong Heart Study. Am
J Epidemiol. 1999; 149: 330–8.
107 Criqui MH, Vargas V, Denenberg JO, etal. Ethnicity and peripheral arterial
disease: the San Diego Population Study. Circulation. 2005; 112: 2703–7.
108 Jepson RG, Fowkes FG, Donnan PT, Housley E. Alcohol intake as a risk
factor for peripheral arterial disease in the general population in the
Edinburgh Artery Study. Eur J Epidemiol. 1995; 11: 9–14.
109 Camargo CA Jr, Stampfer MJ, Glynn RJ, etal. Prospective study of moderate
alcohol consumption and risk of peripheral arterial disease in US male
physicians. Circulation. 1997; 95: 577–80.
110 Rajagopalan S, Dellegrottaglie S, Furniss AL, etal. Peripheral arterial disease
in patients with end‐stage renal disease: observations from the Dialysis
Outcomes and Practice Patterns Study (DOPPS). Circulation. 2006; 114:
1914–22.
111 O’Hare A, Johansen K. Lower‐extremity peripheral arterial disease
amongpatients with end‐stage renal disease. J Am Soc Nephrol. 2001; 12:
2838–47.
112 Asqualini L, Schillaci G, Pirro M, etal. Renal dysfunction predicts long‐term
mortality in patients with lower extremity arterial disease. J Intern Med.
2007; 262: 668–77.
113 Asgeirsdóttir LP, Agnarsson U, Jónsson GS. Lower extremity blood flow in
healthy men: effect of smoking, cholesterol, and physical activity–a Doppler
study. Angiology. 2001; 52: 437–45.
114 McDermott MM, Greenland P, Guralnik JM, etal. Depressive symptoms and
lower extremity functioning in men and women with peripheral arterial
disease. J Gen Intern Med. 2003; 18: 461–7.
115 Navas‐Acien A, Selvin E, Sharrett AR, etal. Lead, cadmium, smoking, and
increased risk of peripheral arterial disease. Circulation. 2004; 109:
3196–201.
116 Hung HC, Willett W, Merchant A, etal. Oral health and peripheral arterial
disease. Circulation. 2003; 107: 1152–7.
https://t.me/med1917
1 Epidemiology ofPeripheral Artery Disease
34
117 Lam EY, Taylor LM Jr, Landry GJ, etal. Relationship between
antiphospholipid antibodies and progression of lower extremity arterial
occlusive disease after lower extremity bypass operations. J Vasc Surg. 2001;
33: 976–82.
118 Eraso LH, Ginwala N, Qasim AN, etal. Association of lower plasma fetuin‐a
levels with peripheral arterial disease in type 2 diabetes. Diabetes Care. 2010;
33(2): 408–10.
119 Carmelli D, Fabsitz RR, Swan GE, etal. Contribution of genetic and
environmental influences to ankle‐brachial blood pressure index in the
NHLBI Twin Study. National Heart, Lung, and Blood Institute. Am J
Epidemiol. 2000; 151: 452–8.
120 Prushik SG, Farber A, Gona P, etal. Parental intermittent claudication as risk
factor for claudication in adults. Am J Cardiol. 2012; 109: 736–41.
121 Wassel CL, Loomba R, Ix JH, etal. Family history of peripheral artery disease
is associated with prevalence and severity of peripheral artery disease: the
San Diego population study. J Am Coll Cardiol. 2011; 58: 1386–92.
122 Duval S, Massaro JM, Jaff MR, etal. REACH Registry Investigators. An
evidence‐based score to detect prevalent peripheral artery disease (PAD).
Vasc Med. 2012; 17(5): 342–51.
123 Hirsch AT, Murphy TP, Lovell MB, etal. Gaps in public knowledge of
peripheral arterial disease: the first national PAD public awareness survey.
Circulation. 2007; 116(18): 2086–94.
124 Hess H, Mietaschk A, Deichsel G. Drug‐induced inhibition of platelet function
delays progression of peripheral occlusive arterial disease: a prospective
double‐blind arteriographically controlled trial. Lancet. 1985; i: 415–19.
125 Jelnes R, Gaardsting O, Hougaard Jensen K, etal. Fate in intermittent
claudication: outcome and risk factors. Br Med J. 1986; 293: 1137–40.
126 Osmundson PJ, O’Fallon WM, Zimmerman BR, etal. Course of peripheral
occlusive arterial disease in diabetes: vascular laboratory assessment.
Diabetes Care. 1990; 13: 143–52.
127 Walsh DB, Gilbertson JJ, Zwolack RM, etal. The natural history of superficial
femoral artery stenoses. J Vasc Surg. 1991; 14: 299–304.
128 Fowkes FG, Lowe GD, Housley E, etal. Cross‐linked fibrin degradation
products, progression of peripheral arterial disease, and risk of coronary
heart disease. Lancet. 1993; 342: 84–6.
129 Bird CE, Criqui MH, Fronek A, etal. Quantitative and qualitative
progression of peripheral arterial disease by non‐invasive testing. Vasc Med.
1999; 4: 15–21.
130 Aboyans V, Criqui MH, Denenberg JO, etal. Risk factors for progression of
peripheral arterial disease in large and small vessels. Circulation. 2006; 113:
2623–9.
131 Smith I, Franks PJ, Greenhalgh RM, etal. The influence of smoking cessation
and hypertriglyceridaemia on the progression of peripheral arterial disease
https://t.me/med1917
References 35
and the onset of critical ischaemia. Eur J Vasc Endovasc Surg. 1996; 11:
402–8.
132 Pairolero PC, Joyce JW, Skinner CR, etal. Lower limb ischemia in young
adults: prognostic implications. J Vasc Surg. 1984; 1: 459–64.
133 Levy PJ, Hornung CA, Haynes JL, Rush DS. Lower extremity ischemia in
adults younger than forty years of age: a community‐wide survey of
premature atherosclerotic arterial disease. J Vasc Surg. 1994; 19(5): 873–81.
134 Mohler ER 3rd, Bundens W, Denenberg J, etal. Progression of asymptomatic
peripheral artery disease over 1 year. Vasc Med. 2012; 17(1): 10–16.
135 Criqui MH, Langer RD, Fronek A, etal. Mortality over a period of 10 years in
patients with peripheral arterial disease. N Engl J Med. 1992; 326: 381–6.
136 Heart Protection Study Collaborative Group. MRC/BHF Heart Protection
Study of cholesterol lowering with simvastatin in 20, 536 high‐risk
individuals: a randomised placebo controlled trial. Lancet. 2002; 360: 7–22.
137 Joint National Committee on Prevention, Detection, Evaluation, and
Treatment of High Blood Pressure. The Seventh Report. NIH publication
No. 04‐5230. Bethesda, MD: National Institutes of Health, 2004.
138 Steg G, Bhatt DL, Wilson PWF, etal. for the REACH Registry Investigators.
One‐year cardiovascular event rates in outpatients with atherothrombosis.
JAMA. 2007; 297: 1197–206.
139 Mehler PS, Coll JR, Estacio R, etal. Intensive blood pressure control reduces
the risk of cardiovascular events in patients with peripheral arterial disease
and type 2 diabetes. Circulation. 2003; 107: 753–6.
140 National Cholesterol Education Program (NCEP) Expert Panel on Detection,
Evaluation, and Treatment of High Blood Cholesterol in Adults: Third
Report of the National Cholesterol Education Program (NCEP) Expert Panel
on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
(Adult Treatment Panel III): Final Report. NIH publication No.02‐5215.
Bethesda, MD: National Institutes of Health; 2002.
https://t.me/med1917
37
Peripheral Artery Disease, Second Edition. Edited by Emile R. Mohler and Michael R. Jaff.
© 2017 John Wiley & Sons Ltd. Published 2017 by John Wiley & Sons Ltd.
2
Introduction
The prevalence of peripheral artery disease (PAD) is estimated to be 3–13%
worldwide and is a major cause of morbidity and mortality in affected individu-
als [1]. It is also a marker of systemic atherosclerosis. Careful history and physi-
cal examination allow for early diagnosis and implementation of interventions
to modify the risk of morbidity and mortality.
The effective medical interview allows for the exchange of pertinent
information in addition to building a therapeutic alliance with the patient.
The diagnosis of PAD can be identified on the basis of a good medical history.
If leg discomfort is not clearly vascular in origin, a differential diagnosis can
be formulated and then further narrowed down by thoughtful physical
examination.
Identifying At-Risk Individuals
Multiple risk factors for PAD have been identified. It is important to identify
the presence of these risk factors in each patient not only for risk assessment
for PAD but also for risk modification.
The National Health and Nutrition Examination Survey (NHANES) in the
United States found that an ankle–brachial index (ABI) ≤ 0.90 was more com-
mon in non‐Hispanic blacks (7.8%) than in whites (4.4%) [2]. This difference
was independent of traditional risk factors [3]. The prevalence of PAD increases
with age in both men and women progressively after the age of 40 years. The
prevalence of PAD, according to NHANES, is about 0.9% in individuals
Office Evaluation of Peripheral Artery
Disease – History and Physical Examination Strategies
Maen Nusair
1
and Robert S. Dieter
2
1
PeaceHealth Southwest Heart and Vascular Center, Vancouver, WA, USA
2
Loyola University Medical Center, Maywood, IL, USA
https://t.me/med1917
2 Office Evaluation ofPeripheral Artery Disease–History andPhysical Examination Strategies
38
between the ages 40–49 years. The prevalence increases to 23.3% in individuals
over 80 years of age [4].
According to the NHANES data, current smoking is associated with an
increased risk of PAD (odds ratio = 3.39) [5]. Furthermore, a diagnosis of PAD
is made approximately a decade earlier in smokers than in non‐smokers. The
severity of PAD tends to increase with the number of cigarettes smoked [2].
The Edinburgh Artery Study found a decreased risk of claudication for patients
who stopped smoking compared with those who continued to smoke [6].
Diabetics are at an increased risk for PAD. It is estimated that for every 1%
increase in hemoglobin A1c, there is a corresponding 26% increased risk of
PAD [7]. In the Framingham study, a fasting total cholesterol level 270 mg/dL
was associated with a doubling of the incidence of intermittent claudication,
and for each 40 mg/dL increase in total serum cholesterol, the odds of develop-
ing symptomatic PAD increased by 1.2 [8]. Statin therapy was shown to
decrease vascular mortality by 17% [9].
Regional Symptom Analysis
Neurologic Symptoms
Cerebrovascular accidents in the form of transient ischemic attack (TIA) or
stroke are frequently a manifestation of vascular disease. TIA is defined as a
transient episode of neurologic dysfunction caused by focal brain, spinal
cord, or retinal ischemia, without acute infarction. Ischemic stroke is, on the
other hand, defined as infarction of central nervous system tissue. This defi-
nition, which is endorsed by the 2009 guidelines of the American Heart
Association and American Stroke Association (AHA/ASA), is a departure
from the classic definition of TIA focal neurologic symptom and/or sign last-
ing less than 24 hours. This tissue‐centric definition emphasizes that there is
a risk of permanent tissue injury (i.e., infarction) even when the focal neuro-
logic symptoms are transient [10]. The specific neurologic deficits can typi-
cally be categorized as anterior circulation or posterior circulation events
(Figure 2.1) [11].
Amaurosis fugax, or transient monocular blindness, occurs when a plaque
travels from the proximal aorta or internal carotid artery to the ipsilateral oph-
thalmic artery. Patients will frequently report monocular vision loss that begins
as haziness in the upper fields and progresses downward, like “a veil” or “a
shade being drawn.” The vision loss usually only lasts for a few seconds or min-
utes [12]. When amaurosis fugax is secondary to carotid artery disease, the
annual risk of stroke is estimated to be 2–3% [13].
The vertebral arteries normally originate from the proximal subclavian arter-
ies, as such disease of the subclavian or innominate arteries proximal to the
https://t.me/med1917
Соседние файлы в папке Библиотека им академика М.И. Перельмана