Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes

Jakubiak, Grzegorz K.; Pawlas, Natalia; Cieślar, Grzegorz; Stanek, Agata

doi:10.3390/ijerph17249339

Cited by 37 publications

(34 citation statements)

References 113 publications

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“…It can lead to amputation [13]. The association between PAD and frailty syndrome in patients living with DM has recently been widely described [14].…”

Section: Peripheral Arterial Disease In the Course Of Diabetesmentioning

confidence: 99%

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2021

IJERPH

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Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Percutaneous balloon angioplasty with or without stent implantation is an important method of the treatment for atherosclerotic cardiovascular diseases, but restenosis is a factor limiting its long-term effectiveness. The pathogenesis of atherosclerosis in the course of DM differs slightly from that in the general population. In the population of people living with DM, more attention is drawn to such factors as inflammation, endothelial dysfunction, platelet dysfunction, blood rheological properties, hypercoagulability, and additional factors stimulating vascular smooth muscle cell proliferation. DM is a risk factor for restenosis. The purpose of this paper is to provide a review of the literature and to present the most important information on the current state of knowledge on mechanisms and the clinical significance of restenosis and in-stent restenosis in patients with DM, especially in association with the endovascular treatment of PAD. The role of such processes as inflammation, neointimal hyperplasia and neoatherosclerosis, allergy, resistance to antimitotic drugs used for coating stents and balloons, genetic factors, and technical and mechanical factors are discussed. The information on restenosis collected in this publication may be helpful in planning further research in this field, which may contribute to the formulation of more and more precise recommendations for the clinical practice.

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“…It can lead to amputation [13]. The association between PAD and frailty syndrome in patients living with DM has recently been widely described [14].…”

Section: Peripheral Arterial Disease In the Course Of Diabetesmentioning

confidence: 99%

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2021

IJERPH

Self Cite

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“…In diabetic patients, the BTK arteries are mainly involved with a characteristic symmetrical and multi-segmental stenosis. For this reason, technical success rate of PTA is lower in PAD with diabetes than that in PAD without diabetes [23]. In addition, a study has reported that males were at an increased risk for re-peripheral vascular interventions compared to females [24].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Cone-Beam CT-Based Perfusion Mapping in Evaluation of Tissue Perfusion in Peripheral Arterial Disease

Kim

Choi

Kim

2021

JCM

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This study investigated the use of cone-beam computed tomography (CBCT)-based perfusion mapping during percutaneous transluminal angioplasty (PTA) to predict clinical outcome in the peripheral arterial disease (PAD). From January 2016 to March 2020, 43 patients (28 male, 15 female; mean age, 69) with 51 limbs, who underwent PTA with CBCT-based foot perfusion mapping for PAD were included. Parenchymal blood volume (PBV) of foot was measured. Clinical response was investigated based on medical records. Predictive value for clinical success was evaluated using multiple logistic regression with C-statistics. Two reviewers visually assessed the improvement on angiography and CBCT-based foot perfusion mapping; inter-observer agreement of clinical success between the two were measured. Technical and clinical success rate of PTA was 90.8% and 68.6%, respectively. In multiple logistic regression, the maximum value of PBV (PBVmax) on perfusion mapping after PTA was significant (p = 0.03) for evaluating clinical success with the highest C-statistic (0.84). Using a cutoff of 235.7 mL/L for PBVmax after PTA, area under curve for prediction of clinical success was 0.664, and sensitivity and specificity were 71.4% and 68.8%, respectively. Consistency in prediction of clinical success between the two reviewers was almost perfect for CBCT-based foot perfusion mapping.

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“…Jakubiak et al also indicated in their literature review that the characteristics of frailty may well affect the clinical course of this condition, treatment efficacy, and complications of chronic lower limb ischaemia [ 35 ]. Moreover, the inflammatory process entailed in the pathogenesis of FS is also encountered in the pathogenesis of atherosclerotic cardiovascular disease and restenosis, following its endovascular treatment, as well as with regard to peripheral arteries [ 36 ].…”

Section: Frailty Syndromementioning

confidence: 99%

Frailty Syndrome—Fall Risk and Rehabilitation Management Aided by Virtual Reality (VR) Technology Solutions: A Narrative Review of the Current Literature

Žák

Sikorski

Wasik

et al. 2022

IJERPH

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Frailty, a physiological syndrome (FS) affecting primarily the older adults, manifests itself through significantly depleted bodily reserves, and appreciably higher (up to over threefold) individual exposure to fall risk. Concomitant medical conditions such as balance impairment, reduced visual acuity, limited mobility, and significantly diminished daily functional performance further exacerbate the patients’ condition. Their resultant susceptibility to frequent hospitalisations makes their prognosis even worse. This narrative review aimed to provide an overview of published studies focused on rehabilitation management approaches aided by virtual reality (VR) technology in frail older adults. The authors had it also augmented with their own, evidence-based body of experience in rehabilitation. Making use of technologically advanced exercise machinery, specially adapted for rehabilitating frail older adults, combined with a structured exercise regimen, further aided by the application of select virtual reality (VR) technology solutions, clearly proved effective. Consequently, the patients were helped to move back from the frail to the pre-frail stage, as well as had their motor and cognitive functions appreciably enhanced. The application of modern technology in rehabilitating older adults over 65, affected by FS, when specifically aided by the select VR technology solutions, was also proven to complement successfully the conventional rehabilitation management. The overall versatility of the VR technology solutions, e.g., adaptation for home use allowing remote supervision, also makes this novel approach to rehabilitation far more appealing to the patients. They find it both very attractive and far more mentally engaging. Its considerable potential lies mostly in being appreciably more effective in bringing in desirable therapeutic outcomes.

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Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes

Cited by 37 publications

References 113 publications

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

The Efficacy of Cone-Beam CT-Based Perfusion Mapping in Evaluation of Tissue Perfusion in Peripheral Arterial Disease

Frailty Syndrome—Fall Risk and Rehabilitation Management Aided by Virtual Reality (VR) Technology Solutions: A Narrative Review of the Current Literature

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