The current situation in the diagnosis and treatment of lower‑limb ischemia
Authors:
E. Maděrová
Published in the journal:
Kardiol Rev Int Med 2008, 10(4): 177-182
Summary
Peripheral arterial obstructive disease (PAOD) refers to the class of cardiovascular diseases that are the main ca use of mortality in developed countri es. As atherosclerosis is the ca use in almost 98 %, PAOD is considered to be the marker of the general cardiovascular risk. The pitfall of this disease lies in the fact that it remains unrecognized in the majority of our patients and that is why it remains without appropriate treatment for a long time. The goal of our therapeutic approach is to reduce general cardiovascular risk and improve the quality of life of our pati ents. The underestimated part of our treatment is regular exercise training, which is as effective as modern revascularisation techniques in the intermediate stages of the disease. Patients with severe forms of ischemi a should be treated urgently, preferably in speci alized vascular centres, which are equipped to use all modern revascularisation methods.
Key words:
peripheral arteri al obstructive disease – atherosclerosis – early di agnosis – exercise training – pharmacotherapy – therapeutic vasculogenesis – revascularisation – vascular centres
Zdroje
1. Karetová D, Staněk F. Angi ologi e pro praxi. Maxdorf 2001.
2. Criqui MH, Fronek A, Barrett- Connor E et al. The prevalence of peripheral arteri al dise ase in a defined populati on. Circulati on 1985; 71: 510– 515.
3. Fontaine R, Kirn M, Ki eny R. Di e chirurgische Behandlung der peripheren Durchblutungsstörungen. Helv Chir Acta 1954; 5/ 6: 499– 533.
4. Rutherford RB. Standards for evalu ating results of interventi onal therapy for peripheral vascular dise ase. Circulati on 1991; 83: I6– I11.
5. Fowkes FG, Ho usley E, Ri emersma RA et al. Smoking, lipids, glucose intolerance, and blo od pressure as risk factors for peripheral atherosclerosis compared with ischemic he art dise ase in the Edinburgh Artery Study. Am J Epidemi ol 1992; 135: 331– 340.
6. Mohler ER 3rd. Peripheral arteri al dise ase: identificati on and implicati ons. Arch Intern Med 2003; 163: 2306– 2314.
7. Karetová D, Ingrischová M, Vojtíšková J. Ischemická choroba dolních končetin – marker celkového kardi ovaskulárního rizika. Practicus 2008; 7: 9– 13.
8. Musil D. Ischemická choroba dolních končetin. Interní Med 2007; 4: 170– 174.
9. Eiberg JP, Lundorf E, Thomsen C et al. Peripheral vascular surgery and magnetic resonance arteri ography – a revi ew. Eur J Vasc Endovasc Surg 2001; 22: 396– 402.
10. Fleischmann D, Hallett RL, Rubin GD. CT angi ography of peripheral arteri al dise ase. J Vasc Interv Radi ol 2006; 17: 3– 26.
11. Cífková R, Býma S, Češka R et al. Prevence kardi ovaskulárních onemocnění v dospělém věku. Společné doporučení českých odborných společností. Vnitr Lek 2005; 51: 1021– 1036.
12. Mohler ER 3rd, Hi att WR, Cre ager MA. Cholesterol reducti on with atorvastatin improves walking distance in pati ents with peripheral arteri al dise ase. Circulati on 2003; 108: 1481– 1486.
13. Hirsch AT, Laskal ZJ, Hertzer NR et al. ACC/ AHA 2005 guidelines for the management of pati ents with peripheral arteri al dise ase (lower extremity, renal, mesenteric, and abdominal aortic): executive summary a collaborative report from the American Associ ati on for Vascular Surgery/ Soci ety for Vascular Surgery, Soci ety for Cardi ovascular Angi ography and Interventi ons, Soci ety for Vascular Medicine and Bi ology, Soci ety of Interventi onal Radi ology, and the ACC/ AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Pati ents With Peripheral Arteri al Dise ase) endorsed by the American Associ ati on of Cardi ovascular and Pulmonary Rehabilitati on; Nati onal He art, Lung, and Blo od Institute; Soci ety for Vascular Nursing; TransAtlantic Inter- Soci ety Consensus; and Vascular Dise ase Fo undati on. J Am Coll Cardi ol 2006; 47: 1239– 1312.
14. Norgren L, Hi att WR, Dormandy JA et al. Inter- Soci ety Consensus for the Management of Peripheral Arteri al Dise ase (TASC II). Eur J Vasc Endovasc Surg 2007; 33: S1– S75.
15. Roztočil K (ed). Trendy so udobé angi ologi e. Galén 2006.
16. Bulvas M. Doporučení pro di agnostiku a léčbu ischemické choroby dolních končetin. Česká angi ologická společnost 2008. [http://www.angi ologi e.cz].
17. Novotný T. So učasnost a budo ucnost buněčné terapi e. Medical Tribune 16/ 2008; A11.
18. Simons M. Angi ogenesis: where do we stand now? Circulati on 2005; 111: 1556– 1566.
19. Chochola M, Pytlík P, Kobylka P et al. Terape utická vaskulogeneze u paci entů s kriticko u končetinovo u ischemi í dolních končetin. Supplementum Cor Vasa 2007; 49: 38.
20. Hirsch AT. Critical limb ischemi a and stem cell rese arch: anchoring hope with informed adverse event reporting. Circulati on 2006; 114: 2581– 2583.
21. Prostano ids for chronic critical leg ischemi a. A randomized, controlled open- label tri al with prostaglandin E1. The ICAI Study Gro up. Ischemi a Cronica degli Arti inferi ori. Ann Intern Med 1999; 130: 412– 421.
22. Kasalová Z. Syndrom di abetické nohy. [http:/ / www.zdravotnickenoviny.cz/ scripts/ detail.php?id=163121].
23. Eliška O, Spáčil J, Štvrtinová V et al. Angi ologi e 2008. Trendy so udobé angi ologi e. Galén 2008.
24. Weitz JI, Byrne J, Clagett GP et al. Di agnosis and Tre atment of Chronic Arteri al Insuffici ency of the Lower Extremiti es: A Critical Revi ew. Circulati on 1996; 94: 3026– 3049.
Štítky
Paediatric cardiology Internal medicine Cardiac surgery CardiologyČlánok vyšiel v časopise
Cardiology Review
2008 Číslo 4
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