Background-An ankle-brachial index (ABI; ratio of ankle and brachial systolic blood pressure) Ͻ0.9 indicates peripheral arterial disease (PAD) and is a strong predictor of cardiovascular events. The aim of the present study was to address the prognostic value of different methods of ABI calculation. Methods and Results-In 831 patients admitted with chest pain for diagnostic heart catheterization, blood pressure of both anterior and posterior tibial arteries was measured. ABI was calculated for each leg with the higher of the 2 ankle pressures (current definition of the American Heart Association) or with the lower of the 2 ankle pressures (modified definition) in relation to the higher of the left or right brachial systolic blood pressure. For each patient, the lower ABI from both legs was used for further evaluation.

Abstract-The use of ␤-receptor blockers in peripheral arterial disease is controversial for their impact on vasomotor tone.The ␤-blocker nebivolol possesses vasodilating, endothelium-dependent, NO-releasing properties that might be beneficial in peripheral arterial disease. The aim of the study was to evaluate the effects and tolerability of nebivolol in comparison with metoprolol in these patients. A total of 128 patients with intermittent claudication and essential hypertension were included and double-blind randomized to receive 5 mg of nebivolol (Nϭ65) or 95 mg of metoprolol (Nϭ63) once daily. End points were changes in ankle-brachial index, initial and absolute claudication distance, endothelial function assessed by flow-mediated dilatation of the brachial artery, blood pressure, and quality of life using the claudication scale questionnaire. End point analysis was possible in 109 patients (85.2%). After the 48-week treatment period, ankle-brachial index and absolute claudication distance improved significantly in both patient groups (PϽ0.05 for both), with no difference across treatments. A significant increase of initial claudication distance was found in the nebivolol group. Adjusted mean change of initial claudication distance was 33.9% after nebivolol (Pϭ0.003) and 16.6% after metoprolol (Pϭ0.12) treatment. Quality of life was not influenced by either treatment, and there was no relevant change in flow-mediated dilatation in patients treated with nebivolol or metoprolol (Pϭ0.16). Both drugs were equally effective in lowering blood pressure. In conclusion, ␤-blocker therapy was well tolerated in patients with intermittent claudication and arterial hypertension during a treatment period of Ϸ1 year. In the direct comparison, there was no significant difference between nebivolol and metoprolol. (Hypertension. 2011;58:148-154.)

We present an experimental setup for monochromatic propagation-based x-ray phase-contrast imaging based on a conventional rotating-copper-anode source, capable of an integrated flux up to 10 8 photons/s at 8 keV. In our study, the system is characterized in terms of spatial coherence, resolution, contrast sensitivity, and stability. Its quantitativeness is demonstrated by comparing theoretical predictions with experimental data on simple wire phantoms both in planar and computerized-tomography-scan geometries. Application to two biological samples of medical interest shows the potential for bioimaging on the millimeter scale with spatial resolution of the order of 10 μm and contrast resolution below 1%. All the scans are performed within laboratory-compatible exposure times, from 10 min to a few hours, and trade-offs between scan time and image quality are discussed.

Late graft patency and limb salvage were good. These factors, combined with a tolerable rate of late aneurysmal degeneration, justify the use of biologic vascular conduits and autologous vein for complex femorodistal reconstructions.

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