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Definition
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Definition
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Definition
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Term
a progressive narrowing (atherosclerosis) of peripheral arteries that limits the blood flow to the lower limbs |
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Definition
Peripheral Arterial Disease (PAD) |
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Term
a symptom of PAD characterized by pain, discomfort, cramping, aching, or fatigue due to insufficient blood flow to meet the metabolic demands of working skeletal muscles while walking (ischemic muscle/lactic acid build-up) |
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Definition
Intermittent Claudication (IC) |
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Term
thromboangitis obliterans |
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Definition
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Historical clues and physical findings of Chronic Critical Limb Ischemia |
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Definition
ischemic rest pain; ischemic ulceration; gangrene |
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Term
acute pain, numbness of arch and toes with leg elevation; most uncomfortable at night while resting in bed, interferes with sleep; Relief with dependent positioning of limb |
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Definition
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distally at ends of toes, over bony prominences on feet; dry, devitalized, black; intense pain |
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Definition
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functional limitation of IC |
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Definition
occurs in muscle groups, not joints; reproducible from one day to the next resolves completely within 2-3 minutes; many patients unable to walk more than 1/2 to 4 blocks |
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Definition
vascular history; physical exam; ankle-brachial index; noninvasive vascular laboratory; ateriography |
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Term
lower extremity systolic pressure/brachial artery systolic pressure |
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Definition
ankle-brachial index (ABI) |
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Definition
95% sensitive and 99% specific for PAD |
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Definition
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Definition
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Definition
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exercise rehabilitation; pharmacologic intervention |
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both tests validated for claudication clinical trials (treadmill protocols) |
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Definition
Constant load test; graded test |
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Term
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Definition
Clopidogrel (prevents ischemic CV events); Cilostazol (improves claudication symptoms) |
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Term
Treatment of ICS symptoms |
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Definition
Pentoxifylline (Trental); Cilostazol (Pletal) |
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Term
methylxanthine derivative; hemorrheologic agent; mean improvement walking: 48 meters |
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Definition
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phosphodiesterase III inhibitor; platelet aggregation with lipid and vasodilatory effects; mean improvement walking: 106 meters |
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Definition
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side effects of Pentoxifylline |
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Definition
dizziness, HA, N/V, stomach discomfort |
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Term
reduction of symptoms in patients with intermittent claudication, as indicated by increased walking distance; Inhibits phosphodiesterase II (increased CAMP) |
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Definition
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Definition
Cimetidine, erythromycin, ketoconazole/itraconazole, fluconazole/miconazole; diltiazem; grapefruit juice |
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Definition
carbamazepine, rifampin, st. johns wort |
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Cilostazol Black Box Warning |
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Definition
decreased survival compared to placebo in pts with class III-IV congestive heart failure; is CI in pts with CHF of any severity |
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