Document Detail


Particularities of peripheral arterial disease managed in vascular surgery in the French West Indies.
MedLine Citation:
PMID:  18391869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epidemiology of peripheral arterial disease is currently unknown in French West Indies (Antilles).
AIMS AND METHODS: The aim of this study is to present peripheral arterial disease (PAD) occurring in the French West Indian subjects through the analysis of our database of vascular surgery. The study population included 754 patients (mean age 73 +/- 10 years), mostly from African descents. The main clinical presentation was critical limb ischemia (66%, including tissue loss in 48% of cases), followed by claudication (20%). The lesions affected the infragenicular arteries in 86% of cases, including 24% isolated to this level as well as 51% combined to femoro-popliteal lesions and only 7% of cases affecting the aorto-iliac level.
RESULTS: Ankle-brachial index was at 0.57 +/- 0.13 and 0.34 +/- 0.22 (p<0.001) in patients with claudication and critical limb ischemia (CLI), respectively. The severity scores were significantly higher in claudicants with aorto-iliac disease and CLI patients with infragenicular lesions. Except for hypertension (85%) and obesity (19%), the other risk factors were differently distributed between the 2 groups. While in the CLI group, patients were older, with higher rates of female sex, diabetes (62% vs. 48%, p<0.001) and severe renal failure, claudicants were significantly younger, with higher rates of smokers among men (75% vs. 51%, p<0.001) and moderate dyslipidemia (52% vs. 36%, p<0.001). The association with carotid stenosis (12%) and ischemic heart disease (18%) were quite uncommon. Renal disease (glomerular filtration rate<60 ml/mn/1.73 m2) was present in 61% of cases.
CONCLUSION: This study highlights clear differences regarding the presentation, localization and associations of PAD in the West Indies subjects managed in vascular surgery, especially with a severe infragenicular disease, even in claudicants. This study suggests the effect of a different distribution of risk factors as well as other ethnic and socio-economic factors.
Authors:
M Deneuville; J M Pierrot; R N'guyen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  101     ISSN:  1875-2136     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-05-29     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  23-9     Citation Subset:  IM    
Affiliation:
Service de chirurgie vasculaire et thoracique, CHU de Pointe-à-Pitre-Abymes, France. m.deneuville@chu-guadeloupe.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Ankle / blood supply
Aortic Diseases / complications,  epidemiology,  etiology,  physiopathology,  surgery*
Blood Pressure
Brachial Artery / physiopathology
Critical Illness
Extremities / blood supply*
Female
Femoral Artery / surgery
Guadeloupe / epidemiology
Humans
Iliac Artery / surgery
Intermittent Claudication / epidemiology,  etiology*,  physiopathology,  surgery
Ischemia / epidemiology,  etiology*,  physiopathology,  surgery
Male
Middle Aged
Peripheral Vascular Diseases / complications,  epidemiology,  etiology,  physiopathology,  surgery*
Popliteal Artery / surgery
Prospective Studies
Risk Factors
Severity of Illness Index
Treatment Outcome
Vascular Surgical Procedures* / statistics & numerical data

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