Zsombor Tóth-Vajna 1, Gergely Tóth-Vajna 2
1 – Heart and Vascular Center, Department of Vascular Surgery, Semmelweis University, (Budapest, Hungary)
2 – 1st Department of Pediatrics, Semmelweis University (Budapest, Hungary)
Introduction: The purpose was to survey the occurrence and severity of lower extremity PAD within the patient population receiving primary health care, with special attention to groups having non-compressible arteries and ABI negative, symptomatic status. We also took the opportunity to test a cost and time efficient screening algorythm for general practitioners.
Method: We screened 854 patients. We used Edinburgh Questionnaire; recorded the medical history, major risk factors, current complaints, medication. We also performed physical examinations, determined the ankle-brachial index (ABI).
Results: 32.2% complained about lower extremity claudication. 21.8% had abnormal ABI values. 19.3% of the patients within the normal ABI range complained about dysbasia. 11.6% were in non-compressible-artery group. The ABI-negative symptomatic” group’s risk factor profile showed a close similarity to the PAD and non-compressible-artery groups.
Conclusion: The percentage of PAD was higher than the number of patients diagnosed using ABI only. Nearly fifth of the population felt into non-compressible-artery and ABI-negative-symptomatic groups and together were defined as “murky zone”. When screening purposely for PAD, these patients deserve special attention, due to the insufficient selectivity and sensitivity measurements. Especially in the case of high risk diabetic patients, further testing (toe-brachial index, vascular ultrasound) is advised.
Doctoral School: Clinical Medicine
Program: Angiology and vascular research
Supervisor: Péter Sótonyi, professor