The following are the major diseases or complications that may be contributed to by peripheral arterial disease (pAVD): Skin and subcutaneous (L00-L99). Chronic ulcerations (ulcers; typical location: sole of foot and big toe). Poor wound healing in the affected area Cardiovascular system (I00-I99) Atherosclerosis (arteriosclerosis, hardening of the arteries) – pAVD is a predictor of … Peripheral Artery Disease: Complications
Peripheral arterial disease (pAVD) can be classified according to Fontaine as follows: Stage Symptoms I Asymptomatic IIa Complaint-free walking distance > 200 m IIb Complaint-free walking distance < 200 m IIc Lesions (injuries) without the presence of critical ischemia (reduced blood flow) III Ischemic pain at rest IV Trophic (nutritional) lesions such as necrosis (dead … Peripheral Artery Disease: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes [ulcerations (skin ulcers) (stage IV according to Fontaine); accompanying symptoms as the disease progresses: Paleness of the affected extremity Clearly thickened nails Shiny skin Hair … Peripheral Artery Disease: Examination
1st-order laboratory parameters-obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Urine status Urine pH Total protein Glucose and ketone bodies (provide information about glucose metabolism). Bilirubin (indicating cholestasis/liver damage) and urobilinogen, gives indication of hemolysis (destruction of red blood cells) as well as liver damage. Nitrite (may indicate an infection of … Peripheral Artery Disease: Test and Diagnosis
Therapeutic Targets Inhibition of the progression of pAVD Risk reduction of peripheral vascular events. Reduction of cardiovascular and cerebrovascular events. Reduction of LDL cholesterol to levels <70 mg/dl or by at least 50% relative to baseline LDL levels [2017 ESC Guidelines]. Reduction of pain Improvement of resilience, walking performance and quality of life Another therapeutic … Peripheral Artery Disease: Drug Therapy
Mandatory medical device diagnostics. Ankle-brachial index* (ABI; examination method that can describe the risk for cardiovascular disease) – for suspected lower extremity occlusive disease (LEAD, lower extremities arterial disease) [see table below]. Color-coded duplex sonography (FKDS; ultrasound examination: combination of a sonographic cross-sectional image (B-scan) and the Doppler sonography method; imaging method in medicine that … Peripheral Artery Disease: Diagnostic Tests
A risk group indicates the possibility that the disease may be associated with the risk of vital nutrient deficiency. The complaint peripheral vascular disease indicates vital nutrient deficiency for: Vitamin D Calcium Within the framework of micronutrient medicine, the following vital substances (micronutrients) are used for prevention: Vitamin B6 Folic acid Vitamin B12 Vitamin E … Peripheral Artery Disease: Micronutrient Therapy
Guideline recommendations [S3 guideline]: For revascularization, preference should be given to endovascular treatment (performed through the blood vessels – from the inside, so to speak) if the same symptomatic improvement can be achieved in the short term and long term as with vascular surgery. (Recommendation grade A, evidence class 1) Note: For TASC-A and TASC-B … Peripheral Artery Disease: Surgical Therapy
To prevent peripheral arterial disease (pAVD), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Micronutrient deficiency (vital substances) – see Prevention with micronutrients. Consumption of stimulants Tobacco (smoking) – relative risk of smokers for pAVD was more than twice their risk for coronary heart disease (CHD) and apoplexy (stroke); for … Peripheral Artery Disease: Prevention
Cardiovascular System (I00-I99). Acute arterial occlusion (acute arterial vascular occlusion). Acrocyanosis – bluish-red discoloration of the hands, feet, and other ends of the body that may be permanent or temporary, resulting from various cardiopulmonary diseases Erythromelalgia (EM; erythro = red, melos = limb, algos = pain) – acral circulatory disorder characterized by seizure-like redness and … Peripheral Artery Disease: Or something else? Differential Diagnosis
Medical history (history of illness) represents an important component in the diagnosis of peripheral arterial disease (pAVD). Family history Is there a history of frequent cardiovascular disease and/or dyslipidemia in your family? Social history Current medical history/systemic medical history (somatic and psychological complaints). Do you suffer from pain in the legs? When does this pain … Peripheral Artery Disease: Medical History
The following symptoms and complaints may indicate peripheral arterial disease (pAVD): Pathognomonic (characteristic of disease) is intermittent claudication. The following symptoms occur: Pain in the muscles (reproducible, rapidly improving after a few minutes at rest) [localizations: see below]. Numbness, fatigue in the muscles. Muscle cramps All these symptoms occur during exertion, that is, when walking, … Peripheral Artery Disease: Symptoms, Complaints, Signs