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Anesthesia for Minimally Invasive Cardiac Surgery
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
Ti Lian Kah, Sophia Ang Bee Leng, Wei Zhang, Lalitha Manickam, Jai Ajitchandra Sule
History of intermittent claudication, rest pain and risks factors for significant atherosclerotic disease such as dialysis dependence, cerebrovascular disease and ischemic heart disease should be elicited. Physical examination should be done to look for signs of peripheral vascular disease. Patients with risk factors may benefit from angiographic and echocardiographic evaluations of the ascending and thoracic aorta. Aortic cannulation may risk dislodging thrombus and atheromatous plaques in these patients.
Peripheral Vascular Disease
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
The term peripheral vascular disease does not have a precise and agreed meaning. When used in the plural, peripheral vascular diseases normally refers to all diseases that affect the arteries, veins and lymphatics of the peripheral vasculature.1 When used in the singular, peripheral vascular disease normally refers to only those diseases that affect arteries; these include atherosclerosis, aortic aneurysm, Buerger’s disease, Raynaud’s syndrome and others.1 The most common is atherosclerosis, in which lipid is deposited in the arterial wall; sometimes peripheral vascular disease refers to this condition only. ‘Peripheral’ refers to the location of disease. Usually peripheral vascular disease includes conditions that affect the arteries serving the lower limbs, sometimes the upper limbs, and less commonly the carotid, renal and other extra coronary arteries.
Palliative care of non-malignant conditions
Published in Rodger Charlton, Primary Palliative Care, 2018
Peripheral vascular disease is a common progressive disease. For severely affected individuals, surgery is the treatment of choice, but some of these patients decline intervention, are too frail, or may have a poor outcome after operation.
Predictive factors and nomogram to evaluate the risk of below-ankle re-amputation in patients with diabetic foot
Published in Current Medical Research and Opinion, 2022
Wentong Dai, Yuan Li, Zexin Huang, Cai Lin, Xing-xing Zhang, Weidong Xia
It is noteworthy that studies on smoking as a risk factor for re-amputation of the diabetic foot have shown inconsistent results. Contrary to our findings, the study by Selby et al.30 has found no significant association between smoking and risk of diabetic-related amputation. However, several recent studies have reported that long-term smoking is associated with a higher rate of re-amputation, suggesting an increased risk of relapse and need for re-amputation in diabetic foot31,32. Moreover, evidence has shown that heavy smokers are more likely to develop peripheral vascular disease due to significant vascular damage and eventually leads to amputation33. Our findings revealed that smoking was an independent risk factor for re-amputation in diabetic foot patients. Correspondingly, peripheral vascular disease, as indicated by low ABI, is a significant factor in the development and delayed healing of diabetic foot ulcers. Patients with a higher peripheral arterial disease have been shown to have a higher rate of re-amputation34. Inadequate oxygen supply due to vascular insufficiency may lead to limb amputation in diabetic patients35.
Internal carotid artery anomaly in oropharynx as a rare cause of sore throat
Published in The Aging Male, 2020
Amira Nasser Al Hail, Nasfareen Zada, Ahmad Al-juboori, Asharaf Ayinikunnan
An anomaly of the internal carotid artery (ICA) is a very rare variation. Normally, the ICA develops from the third aortic arch and the dorsal aorta further up. In fetal life and in infants, the tortuosity of carotid arteries is common. With the descent of heart and elongation of the neck, the arteries assume the normal position. If the embryological state persists, it leads to tortuosity or kinking of the arteries [1,2]. In almost all cases, the anomaly was on the right side. This right-sided predominance may be attributed to anatomical influences and factors affecting blood pressure. Furthermore, the typical causes of peripheral vascular disease (i.e. hypertension, hyperlipidaemia and smoking) are probably also contributory factors [3]. Vague abnormal throat sensation or sore throat which is aggravated by swallowing is the main symptom, or the patient may be presented with oropharyngeal swelling [4]. It is important for otolaryngologists to recognize this anomaly because an abnormal carotid artery is at risk for fatal hemorrhage during pharyngeal procedures, both major (e.g. oropharyngeal tumor resection) and less extensive (e.g. tonsillectomy, adenoidectomy). This condition is often diagnosed on the basis of radiological examinations such as contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography, and digital subtraction angiography [3].
Physical therapy for nocturnal lower limb cramping: A case report
Published in Physiotherapy Theory and Practice, 2019
Addison Williams Andrews, Richard Pine
Additionally, it is also important to conduct a differential diagnosis by ruling out the following similar conditions: restless leg syndrome (RLS), periodic limb movements, peripheral vascular disease, peripheral neuropathy, or dystonia. As compared to nocturnal lower limb cramps, RLS is characterized by continuous discomfort and the urge to move the legs is relieved by movement. They recur at brief intervals and are not associated with the muscle hardening, pain, or the need for forceful stretching as seen with nocturnal lower limb cramps. Peripheral vascular disease may lead to decreased peripheral pulses and lower extremity claudication. This tends to occur during limb use and in contrast to nocturnal cramps, is typically relieved by rest. Peripheral neuropathy may lead to muscle cramps secondary to nerve damage or muscle pathology. However, peripheral neuropathy also typically presents with other sensory or motor findings. Dystonia is typically a result of neurological disease and may present as muscle cramps due to the abnormal muscle spasms and posture. In contrast however, nocturnal lower limb cramps do not involve agonist and antagonist muscle co-contraction (Hallegraeff, van der Schans, de Ruiter, and de Greef, 2012; Monderer, Wu, and Thorpy, 2010).