Related Experiment Video
Updated: Jun 23, 2026
05:06
Effects of Mindfulness Training Combined with Tai Chi in Patients with Diabetic Peripheral Neuropathy
Published on: July 14, 2023
Peripheral arterial disease and diabetes: a clinical update
Thanh Dinh1, Sherry Scovell, Aristidis Veves
1Microcirculation Laboratory and Joslin-Beth Israel Deaconess Foot Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
The International Journal of Lower Extremity Wounds
|May 16, 2009
Summary
Peripheral arterial disease (PAD) reduces blood flow to extremities due to atherosclerosis, especially in diabetics. Revascularization is crucial for healing nonhealing wounds in PAD patients, with surgical or endovascular options available.
Area of Science:
- Vascular Surgery
- Cardiology
- Diabetology
Background:
- Peripheral arterial disease (PAD) involves atherosclerosis, reducing limb blood flow.
- Diabetic PAD often affects infrapopliteal vessels and impairs microcirculation.
- Nonhealing wounds in PAD necessitate revascularization for healing.
Purpose of the Study:
- To review revascularization strategies for peripheral arterial disease impacting wound healing.
- To compare traditional bypass surgery with endovascular interventions.
- To emphasize patient-specific factors in choosing revascularization methods.
Main Methods:
- Review of current literature on peripheral arterial disease and revascularization techniques.
- Comparison of surgical bypass, angioplasty, and stenting for PAD.
- Analysis of factors influencing revascularization outcomes in diabetic patients.
Main Results:
- Atherosclerosis in diabetes characteristically affects infrapopliteal vessels.
- Endovascular revascularization offers faster recovery and lower morbidity than bypass.
- Durability of endovascular procedures may be less than traditional bypass.
Conclusions:
- Revascularization is essential for nonhealing wounds in peripheral arterial disease.
- Both surgical bypass and endovascular interventions are viable revascularization options.
- Treatment choice depends on lesion characteristics and patient history.
Related Concept Videos
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
01:30Peripheral Artery Disease I: Introduction
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
01:26Peripheral Artery Disease IV: Nursing Management
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
01:22Diabetic Neuropathy
DefinitionDiabetic neuropathy is nerve damage caused by long-standing diabetes mellitus. It results directly from prolonged high blood sugar levels.PathophysiologyThe pathophysiology of diabetic neuropathy involves both metabolic and vascular disturbances triggered by chronic hyperglycemia.Metabolic injury: Elevated glucose levels activate the polyol pathway within nerve cells, leading to the accumulation of sorbitol and fructose. This increases oxidative stress, disrupts normal nerve...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
01:27Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...