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MESI ABPI MD Journal of Vascular Health and Risk Management
TASC II Guidelines
Primary care physicians are in a pivotal position within the healthcare system to improve the standard of care for patients with PAD. This improvement can be achieved if physicians follow guidelines and measure ABI on all patients in the cardiovascular risk group, regardless of presenting symptoms.
Continue reading, New 2017 ESC Guidelines on PAD
INTERNATIONAL GUIDELINES:– 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease– 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)– TASC II Inter-society consensus for the management of PAD
FURTHER READING:– Jill J. F. Belch, MD; Eric J. Topol, MD; Giancarlo Agnelli, MD; et al, Critical issues in Peripheral Arterial Disease detection and management, Arch Intern Med. 2003– C. Diehm, H. Darius, et al, Prognostic value of a low post-exercise Ankle-Brachial Index as assessed by primary care physicians, Atherosclerosis 2011– H. van Langen, J. van Grup, et al, Interobserver variability of Ankle–Brachial Index measurements at rest and post exercise in patients with intermittent claudication, Vascular Medicine, 2009
According to new 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS), “it is the outmost importance that every cardiologist should be sensitive to the diagnosis and management of patients with PADs,…”
Measurements of the Ankle-Brachial Index may improve the accuracy of cardiovascular risk prediction beyond the Framingham Risk Score. Furthermore, ABI is valuable for assessing the ability of rehabilitation after cardiac procedures or treatment.
INTERNATIONAL GUIDELINES:– 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)
FURTHER READING:– Ankle-brachial index combined with Framingham risk score to predict cardiovascular events and mortality: a meta-analysis, JAMA, 2008
Ankle-Brachial Index should be the first measurement in wound care, to predict the heal-ability of lower leg wounds. It rules out arterial condition and therefore determines the safe level of compression.
Automated ABPI testing improves patient outcomes in wound care
Continue reading, Vascular assessment for medical compression.
FURTHER READING:– Worldwidewounds.com. (2017). Doppler assessment and ABPI: Interpretation in the management of leg ulceration.– Ankle Brachial Index. (2012). Journal of Wound, Ostomy and Continence Nursing, 39, pp.S21-S29.– Compression for Primary Prevention, Treatment, and Prevention of Recurrence of Venous Leg Ulcers: An Evidence-and Consensus-Based Algorithm for Care Across the Continuum, Journal of Wound Ostomy & Continence Nursing, 2016
Kidney disease is an independent risk factor for the development of PAD. According to KDOQI guidelines, all patients should be evaluated for PAD at the time of dialysis. The disease in those patients progresses faster than in patients without kidney disease.
Continue reading, Chronic Kidney disease and blocked arteries?
INTERNATIONAL GUIDELINES:– K/DOQI Clinical Practice Guidelines for Cardiovascular Disease in Dialysis Patients
– DeLoach, S. and Mohler, E. (2007). Peripheral Arterial Disease: A Guide for Nephrologists. Clinical Journal of the American Society of Nephrology
Ankle-Brachial Index (ABI) is used as a screening tool to determine the possible presence of Peripheral Arterial Disease (PAD)and therefore indicate further management. It is especially useful in the post-operative care of revascularized patients.
A screening Ankle-Brachial Index (ABI) should be considered in diabetic patients above 50 years of age who have other PAD risk factors (e.g., smoking, hypertension, hyperlipidemia, or duration of diabetes for 10 years). If ABI is normal, the measurement has to be repeated every five years.
FURTHER READING:– IWGDF guidance on the diagnosis, prognosis and management of peripheral artery disease in patients with foot ulcers in diabetes– X. Jin, J. Ma, Y. Shen, An Analysis of the Relationship Between Ankle–Brachial Index and Estimated Glomerular Filtration Rate in Type 2 Diabetes
Measurements of the Ankle-Brachial Index are essential in the differential diagnosis of lower extremity pain. In addition, a recurrent ischemia associated with PAD may cause muscle denervation, which may be one of the mechanisms responsible for decreased exercise performance in these patients.
FURTHER READING:– J. D. England, J. G. Regensteiner, S. P. Ringel, M. R. Carry, W. R. Hiatt, Muscle denervation in Peripheral Arterial Disease, Neurology, 1992– Heidrich, Hermann, Concomitant neurological and orthopaedic diseases in the presence of peripheral arterial disease: A prospective study. VASA, 2013
Measurements of the Ankle-Brachial Index (ABI) are essential in the differential diagnosis of lower extremity pain.
FURTHER READING:– Heidrich, Hermann, Concomitant neurological and orthopaedic diseases in the presence of peripheral arterial disease: A prospective study. VASA, 2013– J. Bernstein, J. L. Esterhai, M. Staska, S. Reinhardt, M. E. Mitchell, The prevalence of occult peripheral arterial disease among patients referred for orthopedic evaluation of leg pain, Vascular Medicine, 2008
Measurements of the Ankle-Brachial Index (ABI) contribute to correct indications for surgical therapy and are mandatory in the follow up of patients after surgical treatment.
FURTHER READING:– W.-J. Flu, J.-P. van Kuijk, M.T. Vouˆte, R. Kuiper, H.J.M. Verhagen, J.J. Bax, D. Poldermans. Asymptomatic Low Ankle-Brachial Index in Vascular Surgery Patients: A Predictor of Perioperative Myocardial Damage. European Journal of Vascular & Endovascular Srugery, 2010– Elizabeth M. Mahoney, ScD; Kaijun Wang, MS, PhD, ET AL, Vascular hospitalization rates and costs in patients with Peripheral Artery Disease in the United States, Circulation, November, 2010
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