Peripheral arterial disease: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
A [[systematic review]] by the [http://jama.ama-assn.org/cgi/collection/rational_clinical_exam Rational Clinical Examination] helps guide the [[medical history taking]] and the [[physical examination]].<ref name="pmid16449619">{{cite journal| author=Khan NA, Rahim SA, Anand SS, Simel DL, Panju A| title=Does the clinical examination predict lower extremity peripheral arterial disease? | journal=JAMA | year= 2006 | volume= 295 | issue= 5 | pages= 536-46 | pmid=16449619 | doi=10.1001/jama.295.5.536 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16449619 }} </ref> | [[Clinical practice guideline]]s guide assessment of PAD.<ref>{{Cite journal | doi = 10.1016/j.jacc.2011.08.023 | pages = j.jacc.2011.08.023 | last = Society for Cardiovascular Angiography and Interventions | first = Society of Interventional Radiology | coauthors = Thom W. Rooke, Alan T. Hirsch, Sanjay Misra, Anton N. Sidawy, Joshua A. Beckman, Laura K. Findeiss, Jafar Golzarian, Heather L. Gornik, Jonathan L. Halperin, Michael R. Jaff, Gregory L. Moneta, Jeffrey W. Olin, James C. Stanley, Christopher J. White, John V. White, R. Eugene Zierler | ||
| title = 2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines | journal = J Am Coll Cardiol | accessdate = 2011-09-30 | date = 2011-09-29 | url = http://content.onlinejacc.org }}</ref> A [[systematic review]] by the [http://jama.ama-assn.org/cgi/collection/rational_clinical_exam Rational Clinical Examination] helps guide the [[medical history taking]] and the [[physical examination]].<ref name="pmid16449619">{{cite journal| author=Khan NA, Rahim SA, Anand SS, Simel DL, Panju A| title=Does the clinical examination predict lower extremity peripheral arterial disease? | journal=JAMA | year= 2006 | volume= 295 | issue= 5 | pages= 536-46 | pmid=16449619 | doi=10.1001/jama.295.5.536 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16449619 }} </ref> | |||
===Physical examination=== | ===Physical examination=== | ||
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==Treatment== | ==Treatment== | ||
[[Clinical practice guideline]]s help manage PAD.<ref>{{Cite journal | doi = 10.1016/j.jacc.2011.08.023 | pages = j.jacc.2011.08.023 | last = Society for Cardiovascular Angiography and Interventions | first = Society of Interventional Radiology | coauthors = Thom W. Rooke, Alan T. Hirsch, Sanjay Misra, Anton N. Sidawy, Joshua A. Beckman, Laura K. Findeiss, Jafar Golzarian, Heather L. Gornik, Jonathan L. Halperin, Michael R. Jaff, Gregory L. Moneta, Jeffrey W. Olin, James C. Stanley, Christopher J. White, John V. White, R. Eugene Zierler | |||
| title = 2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines | journal = J Am Coll Cardiol | accessdate = 2011-09-30 | date = 2011-09-29 | url = http://content.onlinejacc.org }}</ref> | |||
Surgery may hasten improvement as compared to a supervised exercise program.<ref name="pmid19188327">{{cite journal |author=Spronk S, Bosch JL, den Hoed PT, Veen HF, Pattynama PM, Hunink MG |title=Intermittent claudication: clinical effectiveness of endovascular revascularization versus supervised hospital-based exercise training--randomized controlled trial |journal=Radiology |volume=250 |issue=2 |pages=586–95 |year=2009 |month=February |pmid=19188327 |doi=10.1148/radiol.2501080607 |url=http://radiology.rsnajnls.org/cgi/pmidlookup?view=long&pmid=19188327 |issn=}}</ref> | Surgery may hasten improvement as compared to a supervised exercise program.<ref name="pmid19188327">{{cite journal |author=Spronk S, Bosch JL, den Hoed PT, Veen HF, Pattynama PM, Hunink MG |title=Intermittent claudication: clinical effectiveness of endovascular revascularization versus supervised hospital-based exercise training--randomized controlled trial |journal=Radiology |volume=250 |issue=2 |pages=586–95 |year=2009 |month=February |pmid=19188327 |doi=10.1148/radiol.2501080607 |url=http://radiology.rsnajnls.org/cgi/pmidlookup?view=long&pmid=19188327 |issn=}}</ref> | ||
Latest revision as of 07:58, 30 September 2011
In medicine, peripheral arterial disease (peripheral artery disease; PAD) is a form of arterial occlusive disease. More specifically, PAD is arteriosclerosis in the arteries of the lower extremities usually from atherosclerosis.
Diagnosis
Clinical practice guidelines guide assessment of PAD.[1] A systematic review by the Rational Clinical Examination helps guide the medical history taking and the physical examination.[2]
Physical examination
On physical examination, the ankle brachial index (ABI) can be estimated by either auscultaton[3] of palpation.
Treatment
Clinical practice guidelines help manage PAD.[4]
Surgery may hasten improvement as compared to a supervised exercise program.[5]
Prognosis
The Revised Cardiac Risk Index may predict short and long term complications among patients undergoing surgery for peripheral arterial disease.[6]
References
- ↑ Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology; Thom W. Rooke, Alan T. Hirsch, Sanjay Misra, Anton N. Sidawy, Joshua A. Beckman, Laura K. Findeiss, Jafar Golzarian, Heather L. Gornik, Jonathan L. Halperin, Michael R. Jaff, Gregory L. Moneta, Jeffrey W. Olin, James C. Stanley, Christopher J. White, John V. White, R. Eugene Zierler (2011-09-29). "2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol: j.jacc.2011.08.023. DOI:10.1016/j.jacc.2011.08.023. Retrieved on 2011-09-30. Research Blogging.
- ↑ Khan NA, Rahim SA, Anand SS, Simel DL, Panju A (2006). "Does the clinical examination predict lower extremity peripheral arterial disease?". JAMA 295 (5): 536-46. DOI:10.1001/jama.295.5.536. PMID 16449619. Research Blogging.
- ↑ Carmo GA, Mandil A, Nascimento BR, Arantes BD, Bittencourt JC, Falqueto EB et al. (2009). "Can we measure the ankle-brachial index using only a stethoscope? A pilot study.". Fam Pract 26 (1): 22-6. DOI:10.1093/fampra/cmn086. PMID 19022870. Research Blogging.
- ↑ Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology; Thom W. Rooke, Alan T. Hirsch, Sanjay Misra, Anton N. Sidawy, Joshua A. Beckman, Laura K. Findeiss, Jafar Golzarian, Heather L. Gornik, Jonathan L. Halperin, Michael R. Jaff, Gregory L. Moneta, Jeffrey W. Olin, James C. Stanley, Christopher J. White, John V. White, R. Eugene Zierler (2011-09-29). "2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol: j.jacc.2011.08.023. DOI:10.1016/j.jacc.2011.08.023. Retrieved on 2011-09-30. Research Blogging.
- ↑ Spronk S, Bosch JL, den Hoed PT, Veen HF, Pattynama PM, Hunink MG (February 2009). "Intermittent claudication: clinical effectiveness of endovascular revascularization versus supervised hospital-based exercise training--randomized controlled trial". Radiology 250 (2): 586–95. DOI:10.1148/radiol.2501080607. PMID 19188327. Research Blogging.
- ↑ Hoeks SE, op Reimer WJ, van Gestel YR, et al. (June 2009). "Preoperative cardiac risk index predicts long-term mortality and health status". Am. J. Med. 122 (6): 559–65. DOI:10.1016/j.amjmed.2008.10.041. PMID 19376487. Research Blogging.