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With the patient supine, note the colour of the feet soles. They should be pink. Then elevate both legs to 45 degrees for more than 1 minute. Observe the soles. If there is marked pallor (whiteness), ischemia should be suspected. Next check for rubor of dependency. Sit the patient upright and observe the feet.
Peripheral artery disease most commonly affects the legs, but other arteries may also be involved, such as those of the arms, neck, or kidneys. [4] [17] Peripheral artery disease (PAD) is a form of peripheral vascular disease. Vascular refers to both the arteries and veins within the body. PAD differs from peripheral veinous disease. PAD means ...
Peripheral artery disease is typically diagnosed if the systolic blood pressure in the ankle divided by the systolic blood pressure in the arm is less than 0.9. In general, claudication is often seen in people with an ABI between 0.4 and 0.9, rest pain is seen between 0.2 and 0.4, and tissue loss, ulcers, and gangrene between 0 to 0.4.
The ABPI test is a popular tool for the non-invasive assessment of Peripheral vascular disease (PVD). Studies have shown the sensitivity of ABPI is 90% with a corresponding 98% specificity for detecting hemodynamically significant (stenosis of more than 50%) in major leg arteries, defined by angiogram. [3] However, ABPI has known issues:
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Acute limb ischaemia (ALI) occurs when there is a sudden lack of blood flow to a limb [1] within 14 days of symptoms onset. [2] On the other hand, when the symptoms exceed 14 days, [3] it is called critical limb ischemia (CLI).
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Peripheral artery disease (PAD) Coronary artery disease (CAD) Atherosclerotic aortic aneurysm (AAA) Two or more of the following risk factors: High blood pressure (hypertension) High cholesterol (hyperlipidemia) Tobacco smoking; Family history – First-degree relative diagnosed with atherosclerosis before age 60 or who had an ischemic stroke