Tags

Type your tag names separated by a space and hit enter

Characteristics of peripheral arterial disease and its relevance to the diabetic population.
Int J Low Extrem Wounds 2011; 10(3):152-66IJ

Abstract

Peripheral arterial disease (PAD) is very frequent in diabetics, and it increases with age. Foot examination contributes poorly to diagnosis of PAD. The ankle-brachial index (ABI) measurement is considered the most accurate noninvasive diagnostic method when evaluating PAD: ABI evaluation is recommended in all diabetics aged >50 years. Many diabetic patients with PAD have a concomitant sensitive neuropathy: as a consequence, perception of ischemic pain is remarkably reduced or completely blocked. The result is that the prevalence of claudication in the diabetic population with PAD is lower than the prevalence of critical limb ischemia (CLI) in this population. CLI is a major risk factor for lower extremity amputation without revascularization. Ankle and toe pressures and oxygen tension at the foot are the noninvasive diagnostic parameters of CLI though the medial artery calcification inhibits accurate determination of the ankle and toe pressures, especially when a forefoot ulcer is present. In diabetics, the anatomical localization is mainly distal; arterial wall calcification is frequently observed and occlusion occurs more frequently than stenosis. Such anatomical features, along with the difficulties in the diagnostic approach, account for the fundamental role of CLI as the main prognostic indicator for major amputation. PAD is an expression of systemic atherosclerotic disease. Prognosis of patients with PAD is related to the presence and extent of underlying coronary artery disease (CAD) but also to the severity of PAD: in particular, patients in whom revascularization is not feasible have the highest mortality rate.

Authors+Show Affiliations

Diabetic Foot Centre, IRCCS MultiMedica, Milan, Italy. ezio.faglia@multimedica.it

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21856972

Citation

Faglia, Ezio. "Characteristics of Peripheral Arterial Disease and Its Relevance to the Diabetic Population." The International Journal of Lower Extremity Wounds, vol. 10, no. 3, 2011, pp. 152-66.
Faglia E. Characteristics of peripheral arterial disease and its relevance to the diabetic population. Int J Low Extrem Wounds. 2011;10(3):152-66.
Faglia, E. (2011). Characteristics of peripheral arterial disease and its relevance to the diabetic population. The International Journal of Lower Extremity Wounds, 10(3), pp. 152-66. doi:10.1177/1534734611417352.
Faglia E. Characteristics of Peripheral Arterial Disease and Its Relevance to the Diabetic Population. Int J Low Extrem Wounds. 2011;10(3):152-66. PubMed PMID: 21856972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of peripheral arterial disease and its relevance to the diabetic population. A1 - Faglia,Ezio, Y1 - 2011/08/19/ PY - 2011/8/23/entrez PY - 2011/8/23/pubmed PY - 2012/1/28/medline SP - 152 EP - 66 JF - The international journal of lower extremity wounds JO - Int J Low Extrem Wounds VL - 10 IS - 3 N2 - Peripheral arterial disease (PAD) is very frequent in diabetics, and it increases with age. Foot examination contributes poorly to diagnosis of PAD. The ankle-brachial index (ABI) measurement is considered the most accurate noninvasive diagnostic method when evaluating PAD: ABI evaluation is recommended in all diabetics aged >50 years. Many diabetic patients with PAD have a concomitant sensitive neuropathy: as a consequence, perception of ischemic pain is remarkably reduced or completely blocked. The result is that the prevalence of claudication in the diabetic population with PAD is lower than the prevalence of critical limb ischemia (CLI) in this population. CLI is a major risk factor for lower extremity amputation without revascularization. Ankle and toe pressures and oxygen tension at the foot are the noninvasive diagnostic parameters of CLI though the medial artery calcification inhibits accurate determination of the ankle and toe pressures, especially when a forefoot ulcer is present. In diabetics, the anatomical localization is mainly distal; arterial wall calcification is frequently observed and occlusion occurs more frequently than stenosis. Such anatomical features, along with the difficulties in the diagnostic approach, account for the fundamental role of CLI as the main prognostic indicator for major amputation. PAD is an expression of systemic atherosclerotic disease. Prognosis of patients with PAD is related to the presence and extent of underlying coronary artery disease (CAD) but also to the severity of PAD: in particular, patients in whom revascularization is not feasible have the highest mortality rate. SN - 1552-6941 UR - https://www.unboundmedicine.com/medline/citation/21856972/Characteristics_of_peripheral_arterial_disease_and_its_relevance_to_the_diabetic_population_ L2 - http://journals.sagepub.com/doi/full/10.1177/1534734611417352?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -