Peripheral arterial disease treatment

The goals of treatment are to lower total and LDL cholesterol in order to reduce the risk of first or recurrent events such as myocardial infarction, angina, heart failure, ischemic stroke, or other forms of peripheral arterial disease such as carotid stenosis or abdominal aortic aneurysm. 

Peripheral vascular disease Treatment with -antagonists reduces cardiac output and can precipitate or aggravate the symptoms of arterial insufficiency in patients with peripheral or mesenteric vascular disease. 

TREATMENT OF PERIPHERAL ARTERY DISEASE AND INTERMITTENT CLAUDICATION... 

A number of studies have investigated the use of PGE1 and PGI2 compounds in Raynaud s phenomenon and peripheral arterial disease. However, these studies are mostly small and uncontrolled, and these therapies do not have an established place in the treatment of this disease. 

Hankey GJ, Norman PE, Eikelboom JW. Medical treatment of peripheral arterial disease. JAMA 2006 295 547-553. 

Thrombolytic agents and antiplatelet therapy, including GPIIb/llla inhibitors, are an important modality in the treatment of peripheral arterial disease. The following section presents the latest published data supporting the use of these relatively new drugs during PPI. 

Urokinase is intended for intravenous use only and indicated for the treatment of pulmonary embolism, coronary artery thrombosis, and intravenous catheter clearance. Typical dosages in peripheral arterial disease consist of an infusion at a rate ranging from 60,000 lU/hr to 240,000 lU/hr infused directly into the thrombus. 

Early experience with this lytic in the treatment of peripheral arterial disease has been promising with equivalent safety and efficacy to alteplase (3 1,32). Burkart et al. published their initial experience in 13 patients with arterial occlusion and five with venous thrombosis. TNK-tPAwas administered at a rate of 0,25 mg/hr with restoration of flow in all patients, The clinical success with respect to limb salvage or symptom relief was achieved in I I of 13 (85%) patients and four out of the five patients with venous thrombosis, There were no intracranial bleeding complications,... 

Comp PC. Treatment of intermittent claudication in peripheral arterial disease. Recent clinical experience with cilostazol. Today s Ther Trends 1999 17 99-112. 

Hirsch AT, Criqui MH, Treat-Jacobson D, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001 286 1317-1324. 

Lindgarde E, Jelnes R, Bjorkman H, et al. Conservative drug treatment in patients with moderately severe chronic occlusive peripheral arterial disease. Scandinavian Smdy Group. Circulation 1989 80 1549-1556. 

Mortality in patients with peripheral vascular disease is most commonly due to cardiovascular disease, and treatment of coronary disease remains the central focus of therapy. Many patients with advanced peripheral arterial disease are more limited by the consequences of peripheral ischemia than by myocardial ischemia. In the cerebral circulation, arterial disease may be manifest as stroke or transient ischemic attacks. The painful symptoms of peripheral arterial disease in the lower extremities (claudication) typically are provoked by exertion, with increases in skeletal muscle O2 demand exceeding blood flow impaired by proximal stenoses. When flow to the extremities becomes critically limiting, peripheral ulcers and rest pain from tissue ischemia can become debilitating. 

Optrin has demonstrated a reduction of atherosclerosis by eliminating inflammatory cells and is actually in Phase II studies for the primary treatment of peripheral artery disease and for the prevention of restenosis following angioplasty [71]. 

The astute clinician understands the differences between the medications in the individual medication classes. All 3-blockers are not considered to be equally safe and effective in treating patients with peripheral arterial disease, reactive airway disease, heart failure, or a cocaine overdose. Not all calcium channel blockers and -blockers may be safely combined for angina treatment, and only certain antihypertensive agents may be used safely during... 

Ticlopidine and clopidogrel are thienopyridines, which through inhibition of platelet aggregation prolong bleeding time and delay clot retraction. The thienopyridines are prescribed for reduction of myocardial infarction and stroke, for treatment of peripheral arterial disease, and in combination with aspirin for acute coronary syndromes. This latter utility appears to result from the fact that both aspirin and the thienopyridines block major amplification pathways, leading to platelet aggregation... 

Symptoms and Treatment Strategies for Peripheral Artery Disease... 

Biomaterials-Based Treatments for Peripheral Artery Disease in Animal Trials... 

Ungerleider, J.L., Christman, K.L. Concise review Injectable biomaterials for the treatment of myocardial infarction and peripheral artery disease Translational challenges and progress. Stem Cells Translational Medicine 3, 1090-1099 (2014) Sun, H., Wang, X., Hu, X., Yu, W., You, C., Hu, H., Han, C. Promotion of angiogenesis by sustained release of rhgm-csf from heparinized coUagen/chitosan scaffolds. J. Biomed. Mater. Res. B Appl. Biomater. 100, 788-798 (2012)... 

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