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AmJCaseRep

Evaluation of combined, conservative treatment impact on the clinical course, blood flow parameters and muscle perfussion in the group of patients with newly diagnosed, untreated peripheral arterial disease (PAD)

Tomasz J. Lesiak, Jacek Mikosiński, Łukasz Piskorz, Wiesław Tryniszewski, Zbigniew Maziarz, Marian Brocki, Jacek Rysz

Med Sci Tech 2010; 51(2): 125-131

ID: 881266

Available online:

Published: 2010-11-15


Background:    Epidemiological studies determined incidence of obliterative atherosclerosis as ranging between 2.45–10%. The course of disease is often asymptomatic and demonstration of symptoms occurs when vascular lesions are significantly advanced. This article discusses conservative treatment of patients with PAD whose key complaint was intermittent claudication. The Authors proposed multi-stage treatment regimen of this disease including lifestyle modification, treatment of comorbid disorders, and pharmacotherapy (aspirin, pentoxifylline, buflomedil, L-arginine). The study evaluated influence of 6-month treatment on clinical course, blood flow parameters as well as muscle perfusion.
    Material/Methods:    The participants included 35 patients (14 women – 40.0%, and 21 men – 60.0%) aged from 49 to 80 (mean age 68.37±10.25 years) first time in life diagnosed with PAD. Physical examination, standard vascular tests (ankle-brachial, thigh-ankle and thigh-shin indices, maximum flow velocity, PI and RI in selected arteries), perfusion scintigraphy of lower limbs muscles at rest and on exertion were carried out before and after 6 months of treatment.
    Results:    Statistically significant increase of total walking distance (198.0 meters vs. 330.0 meters, p<0.01) and improvement in average values of perfusion indices of all studied areas were detected at rest and after exercise. For shin perfusion index at rest (right and left) and for thigh perfusion index after exercise (right) the difference was statistically significant at p<0.05.
    Conclusions:    Combined medical treatment brought on positive effect on patients suffering from recently diagnosed, thus not yet treated atherosclerotic lower limb ischaemia of IIA and IIB stages according to Fontaine’s scale.

Keywords: peripheral arterial disease, treatment, limb ischaemia



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