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World Journal of Cardiology 2024年第7期16卷 397-401页

作者： Moiud Mohyeldin Ahmed S Abuelgasim Ahmed MG Mustafa Department of Internal Medicine University of Medical Sciences and TechnologyKhartoum 11111Sudan

peripheral artery disease(PAD)is a common condition characterized by atherosclerosis in the peripheral arteries,associated with concomitant coronary and cerebrovascular *** convertase subtilisin/kexin type 9(PCSK9)inhibitors are a class of drugs that have shown potential in hypercholesterolemic *** review focuses on the efficacy,safety,and clinical outcomes of PCSK9 inhibitors in PAD based on the literature indexed by *** such as FOURIER and ODYSSEY demonstrate the efficacy of evolocumab and alirocumab in reducing cardiovascular events,offering a potential treatment option for PAD *** evaluations from trials show few adverse events,most of which are injection-site reactions,indicating the overall safety profile of PCSK9 *** outcomes show a reduction in cardiovascular events,ischemic strokes,and major adverse limb ***,despite these positive findings,PCSK9 inhibitors are still underutilized in clinical practice,possibly due to a lack of awareness among care providers and cost *** research is needed to establish the long-term effects and cost-effectiveness of PCSK9 inhibitors in PAD patients.

关键词： peripheral artery disease Proprotein convertase subtilisin/kexin type 9 inhibitors Cardiovascular risk reduction Evolocumab Alirocumab Lipid-lowering therapy Major adverse limb events Clinical outcomes Cost-effectiveness Safety profile

A cross-sectional study on coronary artery disease diagnosis in patients with peripheral artery disease

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Journal of Interventional Medicine 2022年第4期5卷 184-189页

作者： Jai Bharat Bhalke Shirish Hiremath C.N.Makhale Om Multispeciality Hospital OmergaMaharashtraIndia Ruby Hall Clinic PuneIndia

Purpose:Compared with healthy individuals,patients with peripheral artery disease(PAD)generally have a very high risk of subclinical Coronary artery disease(CAD)and cardiovascular *** determine the correlation between CAD in PAD patients,thereby promoting the lifetime of PAD patients and reducing the serious impacts of ***:This clinical-based cross-sectional study comprised 100 consecutive patients in India from 2014 to *** this research,PAD patients were screened for CAD by treadmill stress test and cardiac colour Doppler *** addition,this study performed coronary angiography followed by peripheral angiography for patients who could not perform the treadmill ***:With the statistical results,the study observed a high prevalence of CAD in PAD patients that can be detected only with ***,30.93%of asymptomatic CAD prevalence was observed in PAD *** study strengthens the need for coronary angiography in all symptomatic lower limb PAD cases to detect early CAD,particularly in patients with diabetes and ***:There exists a strong correlation between PAD and ***,precise diagnosis followed by supervision of PAD patients is significant for avoiding local progression of cardiovascular risk.

关键词： peripheral artery disease Coronary artery disease Angiography Cardiovascular risk ABI index

Nerve growth factor in muscle afferent neurons of peripheral artery disease and autonomic function

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Neural Regeneration Research 2021年第4期16卷 694-699页

作者： Lu Qin Jianhua Li Heart&Vascular Institute Penn State University College of MedicineHersheyPAUSA

In peripheral artery disease patients,the blood supply directed to the lower limbs is *** results in severe limb ischemia and thereby enhances pain sensitivity in lower *** painful perception is induced and exaggerate during walking,and is relieved by *** symptom is termed by intermittent *** limb ischemia also amplifies autonomic responses during *** the process of pain and autonomic responses originating exercising muscle,a number of receptors in afferent nerves sense ischemic changes and send signals to the central nervous system leading to autonomic *** review integrates recent study results in terms of perspectives including how nerve growth factor affects muscle sensory nerve receptors in peripheral artery disease and thereby alters responses of sympathetic nerve activity and blood pressure to active *** the sensory nerve receptors,we emphasize the role played by transient receptor potential vanilloid type 1,purinergic P2X purinoceptor 3 and acid sensing ion channel subtype 3 in amplified sympathetic nerve activity responses in peripheral artery disease.

关键词： acid sensing ion channel subtype 3 exercise pressor reflex muscle afferents nerve growth factor P2X purinoceptor 3 peripheral artery disease transient receptor potential vanilloid type 1

Specialty Balloons and Vessel Prepping in peripheral artery disease

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Open Journal of Internal Medicine 2022年第2期12卷 95-102页

作者： Katon Harwood Ariana Harwood James Cappola III Campbell University School of Osteopathic Medicine Lillington NC USA

peripheral artery disease (PAD) is a global disease that affects more than 200 million individuals worldwide with an ever-increasing prevalence rate from year to year. peripheral artery disease treatments include everything from lifestyle interventions to surgical revascularization or percutaneous angioplasty (PTA). Percutaneous Angioplasty (PTA) has become the primary treatment for this disease with the use of focal force and scoring balloons for vessel prepping. The practice of vessel prepping looks to limit the effect of angioplasty on vessel dissection and recoiling in the infrainguinal region during the treatment of plaque buildup in the vessel. Plaque morphology and rise in incidence of in-stent restenosis can determine which balloon device is best used when restoring a vessel. Some of the different brands we review in this chapter include peripheral Cutting Balloons by Boston Scientific, Chocolate PTA by Medtronic, Angiosculpt balloon by Philips, and VascuTrak by BARD. In review of Angiosculpt balloon by Philips: The study concluded that the one-year data supports the notion that the AngioSculpt Scoring Balloon is an effective and safe treatment option for infrapopliteal, atherosclerotic lesions in patients with critical limb ischemia. Whereas: peripheral cutting balloons (PCBs) by Boston Scientific have been used for in-stent restenosis, resistant lesions, small vessels, bifurcations, aortaostial lesions, and saphenous vein graft lesions. This chapter will discuss different focal force and scoring balloon devices available to treat different plaque morphology and usefulness for in-stent restenosis resolution. We will review the evidence associated with each brand of device and the factors that should be accounted for before making a decision on which to use for your patient.

关键词： peripheral artery disease Vessel Prepping Percutaneous Angioplasty

Control of modifiable risk factors and major adverse cardiovascular events in people with peripheral artery disease and diabetes

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World Journal of Diabetes 2021年第6期12卷 883-892页

作者： Jonathan Golledge Aaron Drovandi Sophie Rowbotham Ramesh Velu Frank Quigley Jason Jenkins Queensland Research Centre for peripheral Vascular disease College of Medicine and DentistryJames Cook UniversityTownsville 4811QueenslandAustralia Department of Vascular and Endovascular Surgery Townsville University HospitalTownsville 4811QueenslandAustralia Department of Vascular Surgery Mater HospitalTownsville 4811QueenslandAustralia Department of Vascular Surgery The Royal Brisbane and Women's HospitalBrisbane 4000QueenslandAustralia

BACKGROUND People with diabetes and peripheral artery disease(PAD)have a high risk of major adverse cardiovascular events(MACE).Prior research suggests that medical therapies aimed to control modifiable risk factors are poorly implemented in patients with *** To examine the association between the control of modifiable risk factors,estimated by the novel PAD-medical score,and the incidence of MACE in people with PAD and *** Participants were recruited from out-patient clinics if they had a diagnosis of both PAD and *** of reversible risk factors was assessed by a new composite measure,the PAD-medical *** score takes into account the control of low-density lipoprotein cholesterol,blood pressure,blood glucose,smoking and prescription of an *** were followed to record incidence of myocardial infarction,stroke and cardiovascular death(MACE).The association of PAD-medical score with MACE was assessed using Cox proportional hazard analyses adjusting for age,sex and prior history of ischemic heart disease and *** Between 2002 and 2020,a total of 424 participants with carotid artery disease(n=63),aortic or peripheral aneurysm(n=121)or lower limb ischemia(n=240)were prospectively recruited,and followed for a median duration(inter-quartile range)of 2.0(0.2–4.4)*** 33(7.8%)participants had the optimal PAD-medical score of five,with 318(75%)scoring at least three out of *** were 89(21.0%)participants that had at least one MACE during the follow-up period.A one-unit higher PAD-medical score was associated with lower risk of MACE(HR=0.79,95%CI:0.63-0.98)after adjusting for other risk *** The PAD-medical score provides a simple way to assess the control of modifiable risk factors targeted by medical management aimed to reduce the incidence of MACE.

关键词： peripheral artery disease Diabetes Major cardiovascular events Medical management Prospective study Clinical practice

Ex vivo evaluation of IVUS-VH imaging and the role of plaque structure on peripheral artery disease

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Medicine in Novel Technology and Devices 2020年第4期8卷 22-30页

作者： Christopher Noble Kent Carlson Erica Neumann Bradley Lewis Dan Dragomir-Daescu Amir Lerman Ahmet Erdemir Melissa Young Department of Cardiovascular Medicine Mayo ClinicRochesterMNUSA Department of Physiology and Biomedical Engineering Mayo ClinicRochesterMNUSA Department of Biomedical Engineering and Computational Biomodeling(CoBi)Core Lerner Research InstituteCleveland ClinicClevelandOHUSA Division of Biomedical Statistics and Informatics Mayo ClinicRochesterMNUSA

peripheral artery disease(PAD)results from the buildup of atherosclerotic plaque in the arterial wall,can progress to severe ischemia and lead to tissue necrosis and limb *** evaluated a means of assessing PAD mechanics ex vivo using ten human peripheral arteries with ***-inflation testing was performed at six physiological pressure intervals ranging from 10 to 200 *** vessels were imaged with IVUS-VH to determine plaque composition and change in vessel structure with *** analysis was performed to determine which plaque structures and distributions of these structures had the greatest influence on wall *** found that fibrous plaque,necrotic core,and calcification had a statistically significant effect on all variables(p<0.05).The presence of large concentrations of fibrous plaque was linked to reduced vessel compliance and ellipticity,which could lead to stent fractures and *** the plaque distribution we found that clustered necrotic core increased overall compliance while clustered calcification decreased overall *** effect of plaque distribution on vessel wall deformation must be considered equally important to plaque concentration.

关键词： Intrasvascular ultrasound Virtual histology peripheral artery disease Pressure-inflation testing Atherosclerosis

Use of intravascular lithotripsy in non-coronary artery lesions

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世界心脏病学杂志:英文版(电子版) 2023年第8期15卷 395-405页

作者： Chukwuemeka Anthony Umeh Ashley Stratton Tifani Wagner Shipra Saigal Krystal Sood Raghav Dhawan Cory Wagner Jessica Obi Sabina Kumar Tsung Han Scottie Ching Rahul Gupta Internal Medicine Hemet Global Medical CenterHemetCA 92543United States Department of Cardiology Mclaren Macomb-Oakland/Michigan State UniversityMacombMI 48043United States

BACKGROUND Intravascular lithotripsy(IVL)is a novel technique increasingly used for plaque modification and endovascular revascularization in patients with severe calcification and peripheral artery ***,much of the available literature on IVL is focused on its use in coronary arteries,with relatively limited data on non-coronary artery *** To analyze the safety and efficacy of current IVL use in non-coronary artery lesions,as reported in case reports and case *** We searched EMBASE,PubMed,and Reference Citation Analysis databases for case reports and case series on IVL use in peripheral artery *** then extracted variables of interest and calculated the mean and proportions of these *** We included 60 patients from 33 case reports/case ***-eight percent of the cases had IVL usage in only one blood vessel,while four had the IVL used in two vessels(2.0%),resulting in 64 Lesions treated with *** mean age of the patients was 73.7(SD 10.9).IVL was successfully used in severe iliofemoral artery stenosis(51.6%),severe innominate,subclavian,and carotid artery stenosis(26.7%combined),and severe mesenteric vessel stenosis(9.4%).Additionally,IVL was successfully used in severe renal(7.8%)and aortic artery(4.7%)*** were complications in 12%of the cases,with dissection being the *** IVL has successfully used in plaque modification and endovascular revascularization in severely calcified and challenging lesions in the iliofemoral,carotid,subclavian,aorta,renal,and mesenteric *** most severe but transient complications were with IVL use in the aortic arch and neck arteries.

关键词： Intravascular lithotripsy peripheral artery disease Non-coronary artery

Carbon dioxide-angiography for patients with peripheral arterial disease at risk of contrast-induced nephropathy

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World Journal of Cardiology 2020年第2期12卷 76-90页

作者： Amol Gupta Akinsansoye K Dosekun Vinod Kumar Department of Cardiology HeartVascular and Leg CenterBakersfieldCA 93309United States Department of Nephrology University of TexasHoustonTX 77030United States

Patients with peripheral arterial disease(PAD)and critical limb ischemia are at risk for limb amputation and require urgent management to restore blood *** with PAD often have several comorbidities,including chronic kidney disease,diabetes mellitus,and *** and interventional angiography using iodinated contrast agents provides excellent image resolution but can be associated with contrast-induced nephropathy(CIN).The use of carbon dioxide(CO2)as a contrast agent reduces the volume of iodine contrast required for angiography and reduces the incidence of ***,CO2 angiography has been underutilized due to concerns regarding safety and image *** CO2 delivery systems with advanced digital subtraction angiography techniques and hybrid angiography have improved imaging accuracy and reduced the incidence of *** of the need for optimal imaging conditions,contraindications,and potential complications have improved the safety of CO2 *** review aims to highlight current technological advances in the delivery of CO2 in vascular angiography for patients with PAD and critical limb ischemia,which result in limb preservation while preventing kidney damage.

关键词： Endovascular procedures Angiography Digital subtraction Chronic kidney disease peripheral artery disease Carbon dioxide

Endovascular interventions for TransAtlantic InterSociety Consensus Ⅱ C and D femoropopliteal lesions

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Chinese Medical Journal 2013年第3期126卷 415-420页

作者： YIN Min-yi JIANG Mi-er HUANG Xin-tian LU Min LU Xin-wu HUANG Ying LI Wei-min Department of Vascular Surgery Shanghai 9th People's Hospital Shanghai Jiao Tong University School of Medicine Vascular Center of Shanghai Jiao Tong University Shanghai 200011 China

Background peripheral artery disease accounts for more than 400 000 hospitalizations in the USA and results in symptoms ranging from claudication to gangrene. Recent advances in endovascular techniques have led to a more aggressive approach for treating peripheral artery disease. The aim of this retrospective study was to evaluate the outcomes of endovascular interventions on TransAtlantic InterSociety Consensus （TASC） Ⅱ C and D femoropopliteal occlusive disease. Methods Data for all patients undergoing endovascular interventions for femoropopliteal occlusive disease from December 2007 through December 2010 were reviewed. Demographic data, risk factor data, preprocedural and postprocedural ankle-brachial indices, technical success rates, and complication rates were obtained. Primary, assisted primary, and secondary patency were determined by Kaplan-Meier survival analysis. Univariate and multivariate analyses were performed to identify factors adversely affecting primary patency. Results The study group included 52 TASC Ⅱ C and 106 TASC Ⅱ D limbs in 126 patients （mean age, （68.0±18.0） years） The technical success rate was 91.1%. Complications occurred in 19 limbs （12.0%）, including 8 （5.1%） major complications. The mean follow-up period was （17.6±5.1） months （range, 12.0-48.0 months）. Primary patency rates at 1, 2, 3, and 4 years were 95%, 78%, 74%, and 74% in TASC Ⅱ C lesions and 89%, 62%, 52%, and 52% in TASC Ⅱ D lesions, respectively. Secondary patency rates at 1, 2, 3, and 4 years were 97%, 94%, 94%, and 94% in TASC Ⅱ C lesions and 97%, 95%, 83%, and 83% in TASC Ⅱ D lesions, respectively. It is significantly different between primary patency rates （P 〈0.05） but not secondary patency rates of TASC Ⅱ C and D groups （P 〉0.05）. Predictors of restenosis/occlusion included hyperlipidemia, lesion length, and popliteal artery involvement. Conclusions Endovascular treatment of TASC Ⅱ C and D femoropopliteal artery occlusion has a high technical success rate with favorabl

关键词： peripheral artery disease chronic total occlusion endovascular treatment risk factors restenosis

Overcoming ischemia in the diabetic foot:Minimally invasive treatment options

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World Journal of Diabetes 2021年第12期12卷 2011-2026页

作者： Stavros Spiliopoulos Georgios Festas Ioannis Paraskevopoulos Martin Mariappan Elias Brountzos Second Department of Radiology Interventional Radiology UnitAttikon University HospitalAthens 12461Greece Department of Clinical Radiology Interventional Radiology UnitAberdeen Royal InfirmaryNHS GrampianAberdeen AB252ZNUnited Kingdom Second Department of Radiology School of MedicineNational and Kapodistrian University of AthensAthens 12461Greece

As the global burden of diabetes is rapidly increasing,the incidence of diabetic foot ulcers is continuously increasing as the mean age of the world population increases and the obesity epidemic advances.A significant percentage of diabetic foot ulcers are caused by mixed micro and macro-vascular dysfunction leading to impaired perfusion of foot *** untreated,chronic limb-threatening ischemia has a poor prognosis and is correlated with limb loss and increased mortality;prompt treatment is *** this review,the diagnostic challenges in diabetic foot disease are discussed and available data on minimally invasive treatment options such as endovascular revascularization,stem cells,and gene therapy are examined.

关键词： Diabetic foot peripheral artery disease Critical limb ischemia Endovascular revascularization techniques Gene and stem cells delivery Hyperbaric oxygen treatment