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Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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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...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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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...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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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...
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Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

659
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...
659
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

702
 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,...
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Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
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Atherectomy for peripheral arterial disease.

Graeme K Ambler1, Rami Radwan, Paul D Hayes

  • 1Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, UK, CB2 0QQ.

The Cochrane Database of Systematic Reviews
|March 19, 2014
PubMed
Summary
This summary is machine-generated.

Atherectomy (surgical removal of plaque) shows no clear advantage over balloon angioplasty for peripheral arterial disease. Evidence quality is poor, necessitating further high-quality trials to confirm effectiveness and safety.

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Technology Evaluation

Background:

  • Symptomatic peripheral arterial disease (PAD) has multiple treatment options, including exercise, angioplasty, stenting, and bypass surgery.
  • Atherectomy is an alternative technique involving the excision of atheroma using a rotating blade.

Purpose of the Study:

  • To analyze randomized controlled trials (RCTs) comparing atherectomy with established treatments for PAD.
  • To evaluate the effectiveness of atherectomy in treating symptomatic peripheral arterial disease.

Main Methods:

  • Searched Cochrane Peripheral Vascular Diseases Group Specialised Register and CENTRAL.
  • Included RCTs comparing atherectomy with other established PAD treatments.
  • Two reviewers extracted data and assessed trial quality, resolving disagreements through discussion.

Main Results:

  • Four trials with 220 participants compared atherectomy to balloon angioplasty.
  • No significant differences in procedural success, 6-month, or 12-month patency rates were found.
  • Atherectomy showed a reduction in bailout stenting and lower balloon inflation pressures, but evidence quality was poor with high bias risk.

Conclusions:

  • Poor quality evidence suggests atherectomy is not superior to balloon angioplasty for PAD.
  • Further properly powered trials are recommended to definitively assess atherectomy's efficacy and safety.