Transcript of ENFERMEDAD ARTERIAL PERIFERICA agudos o crónicos, generalmente derivados de una enfermedad arterial oclusiva que. ES UNA ENFERMEDAD ARTERIAL OCLUSIVA DE LOS MIEMBROS LA CIRCULACION CEREBRAL, CARDIACA Y PERIFERICA. Request PDF on ResearchGate | Enfermedad arterial periférica: aspectos fisiopatológicos, clínicos y terapéuticos | Peripheral artery disease is one of the most.

Author: Vurg Dikora
Country: Denmark
Language: English (Spanish)
Genre: Technology
Published (Last): 21 July 2014
Pages: 53
PDF File Size: 12.95 Mb
ePub File Size: 20.84 Mb
ISBN: 992-5-23230-517-6
Downloads: 51707
Price: Free* [*Free Regsitration Required]
Uploader: Tojora

Arterio- scler Thromb Vasc Biol ; Platelet aggregation inhibitors Aspirin or acetylsalicylic acid is widely used for prevention of ischemic events in patients with cardiovascular disease. Currently these indications are being revisited as a result of a recent metaanalysis published in by Amendt The recommendation thus stands on the use of statins at adequate dosages.


Treadmill exercise and resistance training in patients with peripheral arterial disease artrrial and without intermittent claudication: BMC Cardiovasc Disord ; A systematic review of the significance of clinical signs was published in by Khan et al In two different studies published inthe effect of statins vs.

A recent survey by Taylor et al.

At present, there are no studies to show any improvement in management with combination therapy. Med Decis Making ; The method for calculating the index is the ratio of the highest ankle systolic pressure divided by the highest brachial systolic pressure in each side The exact mechanisms by which it improves claudication distance are still unknown and additional effects may explain them Eur J Vasc Surg ;5: This classification can vary, however, because a subset of patients who enfermmedad initially classified in enferedad I, have pain only with specific forms of exercise or only induced with extreme exercise as mentioned earlier.

The indication to intervene a patient surgically has changed inversely to the former indications for medical therapy. PGE1 and other prostaglandins in the treatment of intermittent claudication: It analyzed 8 randomized controlled trials evaluating the effect of Cilostazol on quality of life including the use of SF questionnaires Even in patients without specific training, higher daily physical activity reduces de functional decline of walking distance and intermittent claudication In sedentary patients symptoms may therefore not be apparent initially unless a stress test is applied.


Understanding medical treatment in lower limb peripheral arterial disease

This information is valuable for current treatment and for prevention of further complications following therapy. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. The most reliable clinical sign to predict the presence of PAD was the absence or presence of palpable pulses. Similarly, in the Italian study, additional to walking distance, ABPI and quality of life was measured with or without simvastatin treatment.

Management of peripheral arterial disease in primary care. In addition to these findings, in more recent studies including the media-intimae thickness of carotid arteries, statins may have an overall enfermedzd effect on the thickness of plaques, a direct effect on the endothelial dysfunction in patients perifefica PAD.

Meta-analysis of results from eight randomized, placebo-controlled trials on the effect of cilostazol on patients with intermittent claudication. Muscles have to arterual to the chronic lack of blood, and hence oxygen supply, to improve the use of ooclusiva stores without producing lactate The multimodal medical management, using statins, vasodilator agents, platelet aggregation inhibitor therapy and exercise training is not only limited to patients with concurrent disease.

A risk profile from the Framingham Heart Study. At present, there are several studies addressing this issue. Ankle-arm index as a marker of fnfermedad in the Cardiovascular Health Study. Currently, this form of treatment is surpassing traditional surgery for the management of intermittent claudication. Clopidrogel was equally safe to aspirin in regards to thrombocytopenia. A summary of the management algorithm is depicted in figure 1.

Calf muscle adaptation in intermittent claudication.

Enfermedad arterial periférica (PAD)

The placebo had no effect whatsoever on improvement of walking distance Rev CES Med ;24 2: With the patient lying supine, the pressure cuff of the sphygmomanometer is placed two finger-breadths above the pulse.

Functional assessment of the degree of arterial compromise can be achieved by asking the patient to describe the nature of the symptoms, at what distance usually measured in meters they occur, if the pain subsides after walking and if it’s present at rest or forces him to leave his bed at nighttime. Statins and improvement of quality of life More than 40 years ago, the association between high cholesterol levels and cardiovascular disease was established Clinical Physiology ;8 1: How to cite this article.


Most additional therapies are aimed at causing vasodilatation to improve oxygen delivery via the collateral blood flow system. J Intern Med ; 3: This was the first study to show direct evidence of the benefit of low dose aspirin in this context and current recommendations include the use of a low dose platelet aggregation inhibitor agent, but not combination therapy.

The women’s health and aging study. Vascular surgery is unique amongst surgical specialties, because it includes not only surgical treatment options but also non-invasive medical therapies for patients with peripheral arterial disease PAD. In addition, Cilostazol was not associated with any mayor adverse events including cardiovascular events or mortality in patients receiving Cilostazol compared with placebo.

Reducing cholesterol level improves mortality risk from cardiac and vascular diseases as it was first established in the ancillary 4-S trial with simvastatin in It seems that not only are there beneficial effects of statins on cholesterol levels, but also on the functional capacity of patients with PAD and the rate of decline in functional status over time.

It is very important to ask how long the pain persists after the patient has stopped walking; typical claudicants require less than 10 minutes of rest to resume activities. It is also very useful in determining the outcomes of any therapeutical approach The ankle brachial index is associated with the magnitude of impaired walking endurance among men and women with peripheral arterial disease.