Peripheral artery occlusive disease
{{{Name|Peripheral artery occlusive disease}}}
[[Image:{{{Image}}}|190px|center|]]
{{{Caption|}}}
|
| ICD-10
| I73
|
| ICD-O:
| {{{ICDO}}}
|
| ICD-9
| 443
|
| OMIM
| }}}
|
| MedlinePlus
| }}}
|
| eMedicine
| }}}
|
| DiseasesDB
| }}}
|
In medicine(vascular surgery), Peripheral artery occlusive disease (PAOD) (also known as Peripheral vascular disease or PVD) is a collator for all diseasecaused by the obstruction of large peripheral arteries, which can result from atherosclerosis, inflammatoryprocesses leading to stenosis, an embolismor thrombusformation.
It causes either acuteor chronicischemia.
Inhaltsverzeichnis
- 1 Classification
- 2 Causes
- 3 Diagnosis
- 4 Therapy
- 5 Associations
- 6 See also
- 7 External links
|
Classification
Peripheral artery occlusive disease is commonly divided in the Fontaine stages:
- I: mild painon walking ("claudication")
- II: severe pain on walkingrelatively shorter distances (intermittent claudication)
- III: pain while resting
- IV: loss of sensation to the lower part of the extremity
- V: tissueloss (gangrene)
Causes
All causes of atherosclerosisare also causes of PAOD. There is, however, a strong preponderance of diabeticpeople who smoke. A known diabetic who smokes runs an approximately 30% risk of amputationwithin 5 years.
Diagnosis
Upon suspicion of PAOD, the first-line test is the Ankle brachial pressure index(ABPI/ABI) which is a measure of the fall in blood pressure in the arteries supplying the legs. A reduced ABPI (less than 0.9) is consistent with PAOD. Values of ABPI below 0.8 indicate moderate disease and below 0.5 severe disease.
The next step is generally a form of angiography, where a catheter is used to inject radiodense contrast agent into the femoral arteryand selectively guided to the artery in question. Stenosis of the arteries can be identified, and generally correlates with the patient's symptoms.
Therapy
Dependent on the severity of the disease, the following steps can be taken:
- Conservative measures include Smoking cessation(cigarettes promote PAOD and are a risk factor for cardiovascular disease). Regular exercise for those with claudication helps open up alternative small vessels (collateral flow) and the limitation in walking often improves. Medication with aspirinand statins, which reduce clot formation and cholesterol levels, respectively can help with disease progression and address the other cardiovascular risks that the patient is likely to have.
- Angioplasty(PTA or percutaneous transluminal angioplasty) can be done on solitary lesions in large arteries, such as the femoral artery.
- Occasionally, bypassgrafting is needed to circumvent a seriously stenosed area of the arterial vasculature. Generally, the saphenous veinis used, although artificial (Gore-Tex) material is often used for large tracts when the veins are of lesser quality.
- Rarely, sympathectomyis used - removing the nerves that make arteries contract, effectively leading to vasodilatation.
- When gangreneof toes has set in, amputationis often a last resort to stop infected dying tissues from causing septicemia.
Arterial thrombosisor embolism has a dismal prognosis, but is occasionally treated successfully with thrombolysis.
Associations
Many PAOD patients also have angina pectorisor have had myocardial infarction. There is also an increased risk for stroke.
See also
- Peripheral vascular examination
External links
- Peripheral arterial occlusion
- Merck Manual: Peripheral arterial occlusionde:Arterielle Verschlusskrankheit
en:Peripheral artery occlusive disease
ja:????????
nl:Etalagebenen
pt:Doença arterial periférica
This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Peripheral+artery+occlusive+disease Wikipedia article Peripheral artery occlusive disease.
| 
