الفهرس | Only 14 pages are availabe for public view |
Abstract PAD is a major cause of poor quality of life and disability . Clinical manifestaions of PAD was introduced into 4 stages (1) A symtomatic (2) Claudication (3) ischemic rest pain (4) Ulceration and gangrene. In order to diagnose PAD ,systematic physical examination ,pulse palpation of the limbs is necessary. Then bedside doppler ultrasound which determine which patients should be referred for ABI testing . CTA is used to opacify and clearly visualize the lower limb vasculature .However ,MRA has the advantage over CTA of lack of need for nephrotoxic contrast dye .However ,catheter-based contrast angiography remains the gold standard for the definitive diagnois of LEPAD. Management of PAD is divided into non invasive therapy and minimally invasive endovascular revascularization .Non invasive therapy include (1) Behavioral modification (2) Pharmacologic therapy (3) Modification of other comorbidities (4) Gene therapy as new strategy in treatment of PAD (5) Autologous stem cell therapy . Vascular specialists has numerous options of catheters ,stents ,devices and techniques to restore the luminal integrity and blood flow in patients with lower extremity vascular disease such as; (1) Percutaneous transluminal angioplasty(2) Subintimal angioplasty (3) Cryoplasty (4) Cutting and scoring balloons (5) Nitinol stents (6) Drug-Eluting stents (6) Excimer laser. Also new methods has been applied in the treatment of PAD as excisional atherectomy ,percutaneous thrombectomy,aspiration thrombectomy and rheolytic thrombectomy. |