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Evaluation of the Dependency Between the Claudication Distance Reported by the Patient and the Ankle-Brachial Index at Rest, and the Distance Covered on the Treadmill Test in Patients with Lower Limb Ischemia

100%
Grzela T., Migdalski A., Jawień A., Piotrowicz R., Szotkiewicz A.
Polish Journal of Surgery
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2008
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vol. 80
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issue 4
184-189
EN
Views concerning the dependency between the claudication distance and ankle-brachial index values are ambiguous.The aim of the study was to determine the correlation between the distance covered during the treadmill test and ankle-brachial index, and the distance covered during the treadmill test and claudication distance reported by the patient.Material and method. The study group contained 75 patients of both genders, above the age of 40 years, treated at the Vascular Disease Outpatient Clinic, diagnosed with one or both-sided intermittent claudication, and with an ankle-brachial index below 0.9. In all patients we evaluated the ankle-brachial index at rest, considering both lower limbs, as well as the claudication distance on the treadmill test (3.2 km/h, 12° gradient). We determined the distance traveled until the manifestation of pain (distance free of pain), and the distance until complete stop (total walking distance). Analysis always considered one (the worse) lower limb of the patient.Results. There was no correlation between the ankle-brachial index and distance covered during the treadmill test. However, there was a statistically significant dependency between the claudication distance reported by the patient, and that observed during the treadmill test. A moderate correlation was observed between the total walking distance and the claudication distance reported by the patient (r= 0.441, p=0.001).Conclusions. 1. The ankle-brachial index at rest should not be used as a measure of the intensification of lower limb ischemia symptoms in patients with intermittent claudication. 2. The claudication distance reported by the patient only moderately correlates with the total observed walking distance.
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Long Term Effects of Below-the-Knee Angioplasty in Diabetic Patients with Critical Ischemia of Lower Limbs Referred to Sina Hospital During 2010-2011

88%
Zafarghandi M.-R., Nazari I., Taghavi M., Rashidi A., Dardashti S. K., Sadid D., Esmaili L., Mahmoodi S. M., Mousavi M.
Polish Journal of Surgery
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2015
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vol. 86
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issue 12
555-562
EN
Despite significant advances in the treatment of diabetic foot ulcers and below-the-knee critical ischemia, there are ongoing efforts to achieve a method with low complication, high success rate and persistence of long-term effects. The aim of the study was to examine the outcome of angioplasty in patients with below-the-knee critical ischemia referred to Hospital. Material and methods. This semi-experimental study conducted on diabetics patients treated with PTA (Percutaneous transluminal angioplasty) with critical ischemia of lower limbs referred to Sina Hospital. After discharge, the patients were followed weekly for the first month and then monthly up to 12 months. The procedure short-term effects were examined through evaluation of wound healing as well as patients' recovery and pain relief, after one month. Given the distribution type, parametric and non-parametric test were used to compare the results before and after treatment. Pearson's correlation coefficient was used to determine the correlation between variables. Results. Twenty four patients participated in this study. The mean ankle-brachial index (ABI) at baseline was 0.55±0.17. A month after angioplasty, the index increased statistically significant to 0.93±0.16. The mean health score expressed by the patients at baseline was 5.48±1.39. A month after angioplasty, it was significantly increased (6.32±1.24). The mean pain score before enrollment was 6.68±2.52 (according to VAS scale). There was a significant decrease over time (3.45±1.13). The overall mean score of all patients at Rutherford Classification was 3.88±0.63 at baseline. During the 1st month and 6th month follow-up, it was changed to Class 0 that was statistically significant in the first month. Conclusions. This study represents the mid-term outcomes of PTA. Although PTA treatment was associated with improved pain scores, satisfaction with health, classification of limb ischemia and diabetic foot ulcers, the effects only remain short-term and mid-term. However, long-term efficacy of PTA needs to be investigated further.
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