Peripheral arterial disease laboratory findings: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
 
(11 intermediate revisions by 4 users not shown)
Line 2: Line 2:
{{Peripheral arterial disease}}
{{Peripheral arterial disease}}


'''Editors-in-Chief: [[C. Michael Gibson]], M.D., Beth Israel Deaconess Medical Center, Boston, MA; [[User:Bobby Schwartz|Robert G. Schwartz, M.D.]] [mailto:RGSHEAL@aol.com], [http://www.piedmontpmr.com Piedmont Physical Medicine and Rehabilitation, P.A.]; '''Associate Editor-In-Chief:''' {{CZ}}
{{CMG}}; [[User:Bobby Schwartz|Robert G. Schwartz, M.D.]] [mailto:RGSHEAL@aol.com], [http://www.piedmontpmr.com Piedmont Physical Medicine and Rehabilitation, P.A.]; '''Associate Editor-In-Chief:''' {{CZ}}


Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.


==Overview==
==Laboratory Findings==
 
== Typical Noninvasive Vascular Laboratory Tests for Lower Extremity PAD Patients by Clinical Presentation - ACC/AHA Guidelines (DO NOT EDIT)==
 
<table border="1">
<table border="1">
<tr><td>'''Clinical presentation'''</td><td>'''Noninvasive vascular test'''</td></tr>
<tr><td>'''Clinical Presentation'''</td><td>'''Noninvasive Vascular Test'''</td></tr>
<tr><td>Asymptomatic lower extremity PAD</td><td>ABI</td></tr>
<tr><td>Asymptomatic lower extremity PAD</td><td>[[ABI]] (with stress studies for functional claudication)</td></tr>
<tr><td>[[Claudication]]</td><td>[[ABI]], PVR, or segmental pressures; Duplex ultrasound; Exercise test with ABI or assess functional status</td></tr>
<tr><td>[[Claudication]]</td><td>[[ABI]], PVR, or segmental pressures; Duplex ultrasound; Exercise test with ABI; [[PE]] to assess functional status</td></tr>
<tr><td>Possible pseudoclaudication</td><td>[[Exercise test]] with ABI</td></tr>
<tr><td>Possible pseudoclaudication</td><td>[[Exercise test]] with ABI; [[EMG]] and [[MRI]] for neurogenic etiologies</td></tr>
<tr><td>Possible sympathetic pain syndromes</td><td>[[Thermography]] (Sympathetic Skin Response Testing) for [[RSD]] and [[CRPS]]
<tr><td>Postoperative vein graft follow-up</td><td>[[Duplex ultrasound]]</td></tr>
<tr><td>Postoperative vein graft follow-up</td><td>[[Duplex ultrasound]]</td></tr>
<tr><td>Femoral pseudoaneurysm, iliac or popliteal aneurysm</td><td>Duplex ultrasound</td></tr>
<tr><td>Femoral pseudoaneurysm, iliac or popliteal aneurysm</td><td>[[Duplex ultrasound]]</td></tr>
<tr><td>Suspected aortic aneurysm; serial AAA follow-up</td><td>Abdominal ultrasound, CTA, or [[MRA]]</td></tr>
<tr><td>Suspected [[aortic aneurysm]]; serial [[AAA]] follow-up</td><td>Abdominal [[ultrasound]], CTA, or [[MRA]]</td></tr>
<tr><td>Candidate for revascularization</td><td>Duplex ultrasound, MRA, or CTA</td></tr>
<tr><td>Candidate for revascularization</td><td>[[Duplex ultrasound]], [[MR angiography]], or CTA</td></tr>
</table>
</table>
== Laboratory Findings ==
== 2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline)(DO NOT EDIT)<ref name="pmid21959305">{{cite journal |author= |title=2011 ACCF/AHA Focused Update of the Guideline for the Management of patients with peripheral artery disease (Updating the 2005 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines |journal=[[Circulation]] |volume=124 |issue=18 |pages=2020–45 |year=2011 |month=November |pmid=21959305 |doi=10.1161/CIR.0b013e31822e80c3 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=21959305 |accessdate=2012-10-09}}</ref>==
=== Recommendations for Ankle-Brachial Index, Toe-Brachial Index, and Segmental Pressure Examination ===
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' The resting ABI should be used to establish the lower extremity PAD diagnosis in patients with suspected lower extremity PAD, defined as individuals with 1 or more of the following: exertional leg symptoms, nonhealing wounds, age 65 years and older, or 50 years and older with a history of smoking or diabetes.([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' The ABI should be measured in both legs in all new patients with PAD of any severity to confirm the diagnosis of lower extremity PAD and establish a baseline.([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' The toe-brachial index should be used to establish the lower extremity PAD diagnosis in patients in whom lower extremity PAD is clinically suspected but in whom the ABI test is not reliable due to noncompressible vessels (usually patients with long-standing diabetes or advanced age). ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' Leg segmental pressure measurements are useful to establish the lower extremity PAD diagnosis when anatomic localization of lower extremity PAD is required to create a therapeutic plan. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' ABI results should be uniformly reported with noncompressible values defined as greater than 1.40, normal values 1.00 to 1.40, borderline 0.91 to 0.99, and abnormal 0.90 or less. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])<nowiki>"</nowiki>
|}
=== Recommendations for Pulse Volume Recording ===
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIa]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Pulse volume recordings are reasonable to establish the initial lower extremity PAD diagnosis, assess localization and severity, and follow the status of lower extremity revascularization procedures. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])<nowiki>"</nowiki>
|}
=== Recommendations for Treadmill Exercise Testing With and Without ABI Assessments and 6-Minute Walk Test ===
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Exercise treadmill tests are recommended to provide the most objective evidence of the magnitude of the functional limitation of claudication and to measure the response to therapy. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Astandardized exercise protocol (either fixed or graded) with a motorized treadmill should be used to ensure reproducibility of measurements of pain-free walking distance and maximal walking distance. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Exercise treadmill tests with measurement of preexercise and postexercise ABI values are recommended to provide diagnostic data useful in differentiating arterial claudication from nonarterial claudication (“pseudoclaudication”). ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' Exercise treadmill tests should be performed in individuals with claudication who are to undergo exercise training (lower extremity PAD rehabilitation) so as to determine functional capacity, assess nonvascular exercise limitations, and demonstrate the safety of exercise. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIb]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' A 6-minute walk test may be reasonable to provide an objective assessment of the functional limitation of claudication and response to therapy in elderly individuals or others not amenable to treadmill testing. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}


==References==
==References==

Latest revision as of 18:17, 4 October 2014

Peripheral arterial disease Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Peripheral arterial disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Guidelines for Management

Case Studies

Case #1

AHA/ACC Guidelines on Management of Lower Extremity PAD

Guidelines for Clinical Assessment of Lower Extremity PAD

Guidelines for Diagnostic Testing for suspected PAD

Guidelines for Screening for Atherosclerotic Disease in Other Vascular Beds in patients with Lower Extremity PAD

Guidelines for Medical Therapy for Lower Extremity PAD

Guidelines for Structured Exercise Therapy for Lower Extremity PAD

Guidelines for Minimizing Tissue Loss in Lower Extremity PAD

Guidelines for Revascularization of Claudication in Lower Extremity PAD

Guidelines for Management of CLI in Lower Extremity PAD

Guidelines for Management of Acute Limb Ischemial in Lower Extremity PAD

Guidelines for Longitudinal Follow-up for Lower Extremity PAD

Peripheral arterial disease laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Peripheral arterial disease laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Peripheral arterial disease laboratory findings

CDC on Peripheral arterial disease laboratory findings

Peripheral arterial disease laboratory findings in the news

Blogs on Peripheral arterial disease laboratory findings

Directions to Hospitals Treating Peripheral arterial disease

Risk calculators and risk factors for Peripheral arterial disease laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Robert G. Schwartz, M.D. [2], Piedmont Physical Medicine and Rehabilitation, P.A.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3]

Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.

Laboratory Findings

Clinical PresentationNoninvasive Vascular Test
Asymptomatic lower extremity PADABI (with stress studies for functional claudication)
ClaudicationABI, PVR, or segmental pressures; Duplex ultrasound; Exercise test with ABI; PE to assess functional status
Possible pseudoclaudicationExercise test with ABI; EMG and MRI for neurogenic etiologies
Possible sympathetic pain syndromesThermography (Sympathetic Skin Response Testing) for RSD and CRPS
Postoperative vein graft follow-upDuplex ultrasound
Femoral pseudoaneurysm, iliac or popliteal aneurysmDuplex ultrasound
Suspected aortic aneurysm; serial AAA follow-upAbdominal ultrasound, CTA, or MRA
Candidate for revascularizationDuplex ultrasound, MR angiography, or CTA

References


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Peripheral_arterial_disease_laboratory_findings&oldid=1029977"