Gulzar Ahmad Malik, Kashif Kurshid Qureshi, Imtiaz Ahmad.
Peripheral vascular diseases; noninvasive approach for evaluation and treatment.
Professional Med J Jan ;14(1):134-43.

Objectives: To observe the prevalence & presentation and to review the noninvasive approaches for the evaluation and treatment of patients presenting with peripheral vascular diseases at Bahawal Victoria Hospital Bahawalpur. Design: Prospective randomized study. Place and Duration: This study was conducted from July 2003 to June 2005 at the department of Surgery Bahawal Victoria Hospital Bahawalpur. Patients & Methods: Twenty patients, 2 females and 18 males admitted with peripheral vascular diseases (PVD) fulfilling the inclusion criteria were evaluated and treated medically and surgically. A standard noninvasive approach for the evaluation of these patients was adopted by history & thorough clinical examination, Doppler USG of the vessels, Ankle Brachial Indices (ABI), Duplex Scanning and MRI in a few cases. Results: The relative frequency of PVD at BVH Bahawalpur was 1.2%. The majority of patients (60%) were in the 4th decade of life and male (90%). The smoking was exclusively the major predisposing risk factor (90%). The common (90%) presentation of patients was intermittent claudication with 60% gangrenous disease with an average duration of 4years. The lower limbs were involved in 90% cases with 70% bilateral disease. Majority (90%) of the patients was diagnosed clinically and the objective severity of the disease was assessed with Doppler sonography in all the patients. The ABI was <0.5 in 85% cases. The duplex scanning was needed only in 10% patients. The treatment procedures carried out were primary amputation in 45% followed by conservative on medicines 20%, atherectomy in 15%, lumbar sympathectomy in 10% and resection or repair of pseudoaneurysms in 10% of cases. The ultimate rate of amputation at various levels was seen to be 75%. Conclusion: The prevalence of PVD is rapidly increasing in our society which is causing a horrible threat in the form of physical disabilities at a younger age group of poor class mostly.

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