Talk:Peripheral artery disease

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Title[edit]

Shouldn't be the title 'Peripheral arterial disease (PAD)' and 'Peripheral vascular disease' redirects to the first? I think the term 'vascular disease' could confuse arterial disease with varicose veins or even lymphedema. — Preceding unsigned comment added by 193.144.99.21 (talk) 14:15, 5 April 2014 (UTC)

I agree. Can we generate some consensus about moving this page to peripheral artery disease BakerStMD T|C 21:50, 21 November 2014 (UTC)
Yes check.svg Done (Thanks to a helpful admin) BakerStMD T|C 16:48, 13 January 2015 (UTC)

Image[edit]

What do you think about to find a more 'typical' ischemic ulcer, like that: http://www.globalskinatlas.com/imagedetail.cfm?TopLevelid=456&ImageID=1320&did=6 or http://www.globalskinatlas.com/imagedetail.cfm?TopLevelid=1220&ImageID=2886&did=458 The one in the page suggest another concomitant causes as venous insufficiency and arterial hypertension Is difficult to find one picture with an explicit consent of the patient.

I agree. That image looks like venous rather than arterial disease to me. Next time I see a patient with a good typical arterial ulcer I'll ask if I can take a picture and upload it :p BakerStMD T|C 16:49, 13 January 2015 (UTC)
Yes check.svg Done i found a more typical arterial ulcer picture. BakerStMD T|C 17:04, 13 January 2015 (UTC)

Shouldn't[edit]

Shouldn't ABI be Ankle Brachial Index?

Yes, it should. I have corrected it. Axl 22:40, 3 Jun 2005 (UTC)

Isn't this also known as PVOD? —Preceding unsigned comment added by Mkayatta (talkcontribs) 15:27, 18 February 2008 (UTC)

That seems like a less common name. I would prefer to rename the whole article PAD for Peripheral Arterial Diease.

NEW AHA recommendation[edit]

AHA recommended that the name of the syndrome should be peripheral artery disease (PAD) just like the coronary artery disease (CAD). Don't you guys think that we need to acknowledge the recommendation accordingly and talk more about PAD? —Preceding unsigned comment added by Aceofhearts1968 (talkcontribs) 17:05, 8 June 2010 (UTC)

I rather agree. I work in the US (have worked in PVD/PAD surgery in CA, IL and MA) and PVD is indeed usually referred to as PAD. Bakerstmd (talk) 21:40, 6 March 2014 (UTC)

Systematic review[edit]

The medical management of PAOD was recently reviewed: PMID 16449620. JFW | T@lk 21:04, 4 July 2006 (UTC)

Fontaine Stages[edit]

The 5-stage Fontaine staging mentioned in the article is not one I've ever seen before. As far as I know the common Fontaine stages (at least here in Europe) are:

Fontaine I: asymptomatic
Fontaine II: intermittent claudication (sometimes subdivided in IIa: intermittent claudication without impairment or max walking distance >200m and IIb: with impairment or max.walk.dist <200m)
Fontaine III: nightly or rest pain
Fontaine IV: tissue loss (necrosis or non-healing ulcers).
--- Arthurs 11:15, 30 December 2006 (UTC)

An even more recent paper includes infection and wound scores in predicting limb loss. See pmid 24126108. There are lots of classification schema.Bakerstmd (talk) 21:49, 6 March 2014 (UTC)

The classification of Fontaine has changed. The distance criteria has been abonded. — Preceding unsigned comment added by 131.174.230.39 (talk) 11:14, 19 September 2014 (UTC)

Problems with Mechanical Drilling[edit]

of the lower extremity arteries does not seem to be covered in the PAD articles including this one.

What are the results of such surgeries? (infections; residue from shaving plaque; clogging; scar clogging; time span of the improvement of such action; especially where the waist down clogging is extensive, is there really potential for substantial improvement; like several years for example? apparently not--improvement is minimal at best or such things would be discussed!)

The results of usage of the Foxhollow System referred to in a footnote to this article is not covered or is any of the other "drilling methods". Why is this not covered in this article? Why are the dark secrets not discussed? Pugetkid 09:32, 4 June 2007 (UTC)Pugetkid 6-3-07

Notes from a professional[edit]

I do these various tests and diagnosis for a living. And I just wanted to tell people some various things. 1) If you do not have REPEATABLE pain with walking you do not have claudication. Claudication is not a on again off again symptom. It will happen every time. 2) Numbness is not a symptom. Numbness is a nerve problem. If you circulation is so bad that you have numbness in your extremities, that indicates that the circulation is so bad that the nerves have died. In which case you will have accompaning tissue loss. 3) The chances of being able to do angioplasty to repair this is low. Also the length or time for repair with angioplasty is also low. 4) CT as a diagnostic tool is hardly ever used. The only time I know of is when someone is alleragic to the dye used during angioplasty. And with recient advances is ultrsaound we're moving away from even using it for that. 5) The fox method is also hardely ever used (in my area at least), There is a very specific visualiztion that will alow this procedure to be used. Chances are you will need a bypass. —Preceding unsigned comment added by Bloodsage (talkcontribs) 09:38, 29 July 2007


Thank you! Can you please help me change the article to reflect these key aspects? Bakerstmd (talk) 21:51, 6 March 2014 (UTC)

CT angiography[edit]

http://jama.ama-assn.org/cgi/content/abstract/301/4/415 - studies don't say for certain which imaging modality is best. JFW | T@lk 20:41, 28 January 2009 (UTC)

Proposed correction for the daignosis section - CT angiography typically requires 100-150mls of iodine based contrast, just like conventional angiography. —Preceding unsigned comment added by 194.66.84.39 (talk) 10:45, 23 March 2009 (UTC)

Therapy[edit]

"Prevention of foot failure: ketchup on the bottom of your feet."

Er, what??? —Preceding unsigned comment added by 65.161.188.11 (talk) 08:37, 5 February 2010 (UTC)

Trials[edit]

doi:10.1161/CIRCULATIONAHA.114.011021

Circulation, basically a secondary source that says there aren't many good trials. JFW | T@lk 00:23, 12 November 2014 (UTC)

Merge rest pain with PAD[edit]

There really isn't anything at Rest pain. I propose that it be merged with PAD in the signs and symptoms section. BakerStMD T|C 21:49, 13 January 2015 (UTC)

Bakerstmd I'd just redirect that here, to be honest. JFW | T@lk 23:43, 14 January 2015 (UTC)
Yes check.svg Done. BakerStMD T|C 23:59, 14 January 2015 (UTC)

Citations to improve[edit]

From a request for peer reivew on the wp:med talk page: Thought about requesting a formal peer review for Peripheral artery disease, but thought I'd ask here first. From people not too involved, what needs work? I think this might be a B-class article. Would like to bring it to GA, as is High importance. BakerStMD 03:28, 7 April 2015 (UTC)

in terms of references, 12,21,22,23,25-29,30,32,34,35,37-40,42,43,47,48 are non-MEDRS compliant (they are well beyond five years for a review), you might want to look for newer reviews for those...references #20, #33, are both primary sources and should be replaced with reviews. thank you--Ozzie10aaaa (talk) 12:52, 7 April 2015 (UTC)