Remote ischemic preconditioning in patients with intermittent claudication.

Objective: Remote ischemic preconditioning (RIPC) is a phenomenon in which a short period of sub-lethal ischemia in one organ protects against subsequent bouts of ischemia in another organ. We hypothesized that RIPC in patients with intermittent claudication would increase muscle tissue resistance to ischemia, thereby resulting in an increased ability to walk.

Methods: In a claudication clinic, 52 ambulatory patients who presented with complaints of intermittent claudication in the lower limbs associated with an absent or reduced arterial pulse in the symptomatic limb and/or an ankle-brachial index <0.

Oxidized low-density lipoprotein and ankle-brachial pressure index in patients with clinically evident peripheral arterial disease.

Objectives: To investigate whether oxidized low-density lipoprotein is a suitable predictor of peripheral arterial disease severity. The role of oxidized low-density lipoprotein in the pathogenesis of atherosclerosis has already been investigated. Its relevance as a predictor of the appearance and worsening of coronary arterial disease is also well known.

Performance of patients with intermittent claudication undergoing physical training, with or without an aggravation of arterial disease: retrospective cohort study.

Purpose: This was a retrospective cohort study aiming to investigate the clinical outcome of patients with intermittent claudication undergoing physical training in whom there was an aggravation of the arterial disease.

Method: Three hundred and sixty-four patients with claudication who presented with femoropopliteal or tibioperoneal obstructions in at least 1 of the lower limbs and who did not have aortic or bilateral iliac obstructions were included. Forty patients developed new stenoses in previously spared arterial segments (confirmed by duplex scanning), which were proximal to preexisting lesions, and formed the progression group, in contrast to the stable group of patients (n = 324) who did not exhibit this worsening of the disease.

External aggression to the limb as a predictive factor in the evolution of patients undergoing arterial revascularization.

Purpose: A variety of predictive factors for the evolution of arterial grafts in patients with critical ischemia have been well defined in clinical studies, including diabetes mellitus, dialytic renal insufficiency, smoking, and distal arterial runoff. The goal of this study was to determine whether patients with critical ischemia undergoing arterial reconstruction in which ischemic lesions appeared spontaneously, compared to those in which the ischemic lesion appeared following an external aggression to the limb present different patterns of evolution.

Methods: From February 2002 to January 2004, 100 patients undergoing infra-inguinal arterial reconstruction were followed.

Endovascular treatment for intermittent claudication in patients who do not improve with clinical treatment.

Purpose: To study the results including long-term follow-up obtained with endovascular treatment of patients with intermittent claudication who did not experience clinical improvement with conservative treatment.

Methods: From January 1992 to January 2002, 62 of 1380 patients (4.5%) with intermittent claudication underwent endovascular treatment and were followed up for up to 120 months (mean 76 months).

Natural history of stenosis in the iliac arteries in patients with intermittent claudication undergoing clinical treatment.

Purpose: Inspite of the long experience with the treatment of intermittent claudication, little is known about the natural history of stenotic lesions in the iliac segment. With the advent of endovascular treatment, this knowledge has become important.

Methods: Fifty-two stenosis, diagnosed using arteriography, in 38 claudicant patients were analyzed.

Surgical treatment for intermittent claudication in patients who do not improve with clinical treatment.

Objective: To study the results obtained with surgical treatment of patients with intermittent claudication (IC) who did not clinically improve with conservative treatment, accompanied by a long follow-up (average 6 years).

Methods: From January 1992 to January 2002, 26 patients treated surgically in a group of 1380 IC patient, representing 1.88% of the total.

Evaluation of walking capacity over time in 500 patients with intermittent claudication who underwent clinical treatment.

Background: The use of physical training in the treatment of intermittent claudication is well established. However, current data do not provide enough information about the prognosis for each case, and there are no data on how walking distances evolve over time with conservative treatment. The goal of this study was to evaluate improvement in walking capacity among patients with intermittent claudication who underwent unsupervised clinical treatment, observing whether sustained treatment would increase or decrease maximum walking distance, whether after 6 months there was a change in the maximum distance, and whether abstinence from smoking and well-conducted walking exercise had independent effects on the outcome.

Gadolinium magnetic angioresonance in the study of aortoiliac disease.

There is a need for noninvasive methods for the early identification of patients with intermittent claudication who need surgical treatment. Newer magnetic resonance angiography (MRA) techniques allow detailed study of the arterial tree with image quality similar to that of conventional arteriography. From April 1997 to January 2001, 30 patients with intermittent claudication of the lower limbs were studied with both imaging methods.