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Cardiology Core Curriculum - part 10

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Tham khảo tài liệu 'cardiology core curriculum - part 10', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Cardiology Core Curriculum have been equivocal with some patients experiencing benefit and others showing no change in their symptom complex. Cilostazol is a cellular phosphodiesterase inhibitor that is believed to improve claudication through platelet disaggregation and recent studies again suggest modest improvements in exercise capacity among patients with mild to moderate disease. Neither medicine nor exercise substantially alter the natural progression of the disease toward occlusion. Without question the most important risk factor intervention to try and achieve in patients with lower extremity atherosclerosis is smoking cessation which improves symptoms slows disease progression and reduces amputations. Similarly aggressive control of diabetes hypertension and cholesterol is very important. Revascularization therapy Revascularization therapy is aimed at restoring normal flow to the affected limb and includes transluminal angioplasty with stenting and bypass surgery. Transluminal angioplasty and stenting is less invasive than surgery and does not require general anesthesia. However experience with the technique thus far shows that it is most effective when atherosclerosis causes significant stenoses in the larger limb vessels for example iliac and proximal femoral arteries in such cases surgery has excellent long-term benefits for both large and medium caliber vessels further downstream. Surgical therapy for intermittent claudication has been most successful at improving symptoms but does not clearly alter the rate of amputations. Association with coronary artery disease Perhaps the most important issue to be addressed among patients with lower extremity atherosclerosis is that their disease is systemic and affects other circulations. In particular patients with lower extremity atherosclerosis have a high prevalence of coronary artery disease which is often asymptomatic because these patients are sedentary. The mortality of patients with peripheral lower .