Details

Peripheral Artery Disease


Peripheral Artery Disease


2. Aufl.

von: Emile R. Mohler, Michael R. Jaff

86,99 €

Verlag: Wiley-Blackwell
Format: PDF
Veröffentl.: 13.07.2017
ISBN/EAN: 9781118776070
Sprache: englisch
Anzahl Seiten: 208

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Beschreibungen

A comprehensive, quick-reference guide to the diagnosis and management of peripheral artery disease for non-specialists With an aging population subject to an increasing number of health risks, peripheral artery disease (PAD) is on the rise throughout the world. Because of PAD’s direct links to heart attack and stroke, it is critical that internists, surgeons, cardiologists, radiologists, gerontologists, GPs, and family practitioners know how to recognize it and make the best treatment recommendations for their patients. This book provides all the expert, practical information and guidance they need to do just that.  Edited by two thought leaders in PAD diagnosis and treatment, and comprising chapters written by subject matter experts, Peripheral Artery Disease, Second Edition provides clinicians with guidance on how to diagnose and treat one of the most under-diagnosed conditions affecting millions of patients. This updated and revised edition of the popular guide distills the complexities of PAD into clear, actionable advice for busy medical practitioners, providing them with the information they need—when they need it. Provides clinicians with essential information for recognizing and treating this under-diagnosed condition that affects millions of patients Distills the complexities of PAD, from diagnosis to traditional and emerging treatment options, into clear, actionable advice for clinicians Covers PAD epidemiology, office examination, imaging, laboratory evaluation, medical therapy, surgical interventions, endovascular treatments, and much more Reflects the latest PAD Guidelines and Performance Measures established by leading specialty societies Features contributions from internists and surgeons, all recognized experts in PAD Peripheral Artery Disease, Second Edition is an important working reference for internists, cardiologists, radiologists, and surgeons, as well as fellows and residents in those fields.
Contributors xi Preface xiii 1 Epidemiology of Peripheral Artery Disease 1Wobo Bekwelem and Alan T. Hirsch Definitions 1 PAD Clinical Syndromes 2 Prevalence and Incidence 3 Asymptomatic PAD 8 Claudication 10 Atypical Leg Pain 12 Critical Limb Ischemia 12 Acute Limb Ischemia 13 Risk Factors for Development of PAD 13 Tobacco Use 14 Diabetes Mellitus 15 Dyslipidemia 15 Hypertension 16 Homocysteinemia 16 C?]Reactive Protein and Fibrinogen 17 Obesity 17 Other Risk Factors 18 Awareness of PAD in the Community 20 Progression, Natural History, and Outcomes of PAD 20 Progression 20 Natural History and Outcomes 22 Summary 24 References 26 2 Office Evaluation of Peripheral Artery Disease – History and Physical Examination Strategies 37Maen Nusair and Robert S. Dieter Introduction 37 Identifying At-Risk Individuals 37 Regional Symptom Analysis 38 Neurologic Symptoms 38 Thoracic Symptoms 40 Abdominal Pain 41 Extremity Pain 42 Skin Manifestations 44 Physical Examination 46 General Appearance 46 Head and Neck Examination 46 Chest 48 Abdominal Examination 48 Lower Extremity Examination 49 Palpating for Pulses 50 Auscultation 52 References 53 3 Vascular Laboratory Evaluation of Peripheral Artery Disease 57Thomas Rooke Introduction 57 Anatomic 57 Hemodynamic 57 Functional 58 Physiological Testing 58 Background/History 58 Physiological Invasive Testing 58 Physiological Non?]Invasive Testing 58 Vascular Laboratory 59 Doppler 59 Motion Detection 59 Waveform Analysis 60 Plethysmography 60 PVR Amplitude 61 PVR Contour 62 Ankle–Brachial Index (ABI) and Segmental Pressures 63 Tissue Perfusion 65 Transcutaneous Oximetry (TcPO2) 66 Duplex Scanning 67 Background/History 67 Imaging (Anatomy) 67 Doppler (Hemodynamic) 68 Vascular Laboratory Accreditation 69 References 69 4 Magnetic Resonance, Computed Tomographic, and Angiographic Imaging of Peripheral Artery Disease 73Thomas Le, Masahiro Horikawa and John A. Kaufman Introduction 73 Computed Tomography Angiography 73 Basics 73 Image Acquisition and Interpretation 74 Protocol 74 Advantages 76 Pitfalls 76 Calcification 76 Artifacts 76 Radiation Exposure 76 Contrast?]Induced Nephropathy 76 Anaphylaxis 77 Magnetic Resonance Angiography 77 Basics 77 Image Acquisition and Interpretation 77 Protocol 77 Non?]Contrast?]Enhanced MRA 77 Contrast?]Enhanced MRA (CE?]MRA) 78 Post?]Processing and Interpretation 78 Advantages 78 Pitfalls 80 Time 80 Nephrogenic Systemic Fibrosis 80 Bolus Timing 80 Artifacts 80 Other Pitfalls 80 Conventional Angiography 81 Basics 81 Image Acquisition and Interpretation 81 Pre?]Procedure Patient Care 81 Protocol 81 Advantages 82 Pitfalls 82 Contrast?]Induced Nephropathy and Anaphylaxis 82 Artifacts 84 Other Disadvantages 84 Intravascular Ultrasonography 84 Basics 84 Advantages 85 Pitfalls 85 Results 85 Aortoiliac 85 CTA 85 MRA 86 Runoff 86 CTA 86 MRA 86 Pedal 87 CTA 87 MRA 87 Conclusion 87 References 87 5 Non-atherosclerotic Peripheral Artery Disease 91Mitchell D. Weinberg and Ido Weinberg Introduction – Presentation of Peripheral Artery Disease 91 When Should Non-atherosclerotic Causes of PAD Be Suspected? 92 Entities that Make up Non-atherosclerotic PAD 94 Popliteal Artery Entrapment Syndrome 94 External Iliac Artery Endofibrosis 98 Fibromuscular Dysplasia 99 Cystic Adventitial Disease 100 Vasculitis 101 Idiopathic Mid?]aortic Syndrome 102 Arterial Manifestations of Pseudoxanthoma Elasticum 102 Chronic Exertional Compartment Syndrome 103 Musculoskeletal Pathology 103 Diagnostic Evaluation of Patients with Leg Pain with Exertion 104 Treatment Considerations 105 Conclusions 105 References 105 6 Medical Therapy of Peripheral Artery Disease 111Lee Joseph and Esther S. H. Kim Introduction 111 Atherosclerotic Risk Factor Management 111 Hypertension 112 Diabetes Mellitus 113 Hyperlipidemia 114 Tobacco Cessation 114 Antiplatelet Agents 116 Management of Claudication 117 Claudication Pharmacotherapy 118 Cilostazol 118 Exercise Therapy 118 Claudication Management Strategies: A Comparison 119 Lower Extremity Wound Care 120 Summary 121 References 121 7 Endovascular Treatment of Peripheral Artery Disease 129Vikram Prasanna, Jay Giri and R. Kevin Rogers Introduction 129 Clinical Background 129 Intermittent Claudication 129 Critical Limb Ischemia 131 Limb Prognosis/Overall Survival 131 Typical Anatomy in Patients with CLI 131 Patency Issues 131 Indications for Endovascular Therapy for CLI 131 Background for Endovascular Therapy 132 Anatomy 132 Technical Background 136 Preprocedural Imaging 136 Access 138 Anticoagulation 139 Antiplatelet Management 141 Radiation 143 Chronic Total Occlusions 143 Clinical Evidence for Peripheral Intervention 145 Aorto?]Iliac Interventions 145 Angioplasty vs. Stent 146 Polytetrafluoroethylene (PTFE)?]Covered versus Bare Metal Balloon?]Expandable Stents 147 Femoropopliteal Interventions 147 Angioplasty versus Stenting 149 Drug?]Eluting Stents in Femoropopliteal Arteries 149 Drug?]Coated Balloon (DCB) Therapy in Femoropopliteal Disease 150 Covered Stents in Femoropopliteal Disease 151 Atherectomy 152 Specialty Balloons 153 Tibioperoneal and Pedal Interventions 153 Post-procedural Care 155 Conclusion 155 References 156 8 Surgical Management of Peripheral Artery Disease 163Julia Glaser and Scott M. Damrauer When to Refer Patients with Claudication 163 When to Refer Patients with CLI 164 Revascularization Options and Results 166 Iliac Revascularizations 166 Femoropopliteal Disease 169 Tibioperoneal Disease 171 Complications of Revascularization 173 Preoperative Evaluation and Management 175 Conclusion 175 References 176 Index 179
Emile R. Mohler, MD, MSVM, FACC, FAHA is Director of Vascular Medicine for the University of Pennsylvania Health System, and Professor of Medicine for the Perelman School of Medicine at the University of Pennsylvania, Philadelphia Pennsylvania, USA Michael R. Jaff, DO, FACP, FACC, FAHA, MSVM is Professor of Medicine, Harvard Medical School and President of Newton-Wellesley Hospital in Newton, Massachusetts, USA.
A comprehensive, quick-reference guide to the diagnosis and management of peripheral artery disease for non-specialists With an aging population subject to an increasing number of health risks, peripheral artery disease (PAD) is on the rise throughout the world. Because of PAD's direct links to heart attack and stroke, it is critical that internists, surgeons, cardiologists, radiologists, gerontologists, GPs, and family practitioners know how to recognize it and make the best treatment recommendations for their patients. This book provides all the expert, practical information and guidance they need to do just that. Edited by two thought leaders in PAD diagnosis and treatment, and comprising chapters written by subject matter experts, Peripheral Artery Disease, Second Edition provides clinicians with guidance on how to diagnose and treat one of the most under-diagnosed conditions affecting millions of patients. This updated and revised edition of the popular guide distills the complexities of PAD into clear, actionable advice for busy medical practitioners, providing them with the information they need—when they need it. Provides clinicians with essential information for recognizing and treating this under-diagnosed condition that affects millions of patients Distills the complexities of PAD, from diagnosis to traditional and emerging treatment options, into clear, actionable advice for clinicians Covers PAD epidemiology, office examination, imaging, laboratory evaluation, medical therapy, surgical interventions, endovascular treatments, and much more Reflects the latest PAD Guidelines and Performance Measures established by leading specialty societies Features contributions from internists and surgeons, all recognized experts in PAD   Peripheral Artery Disease, Second Edition is an important working reference for internists, cardiologists, radiologists, and surgeons, as well as fellows and residents in those fields.

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