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Peripheral Arterial Occlusive Disease

Aka: Peripheral Arterial Occlusive Disease, Peripheral Arterial Disease, Peripheral Vascular Disease, Arterial Insufficiency, Claudication, Vascular Claudication, Aortoilliac Occlusive Disease, Leriche's Syndrome, Iliac Artery Stenosis, Iliofemoral Occlusive Disease, Femoropopliteal Occlusive Disease, Femoropopliteal Stenosis, Femoral Arterial Stenosis, Intermittent Claudication, Acute Limb Ischemia, Critical Limb Ischemia, Limb Threatening Ischemia
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  1. See Also
    1. Peripheral Vascular Disease Management (Claudication Management)
  2. History
    1. Claudication derived from latin claudicatio, to limp
  3. Epidemiology: Prevalence
    1. Overall: 7-12 million affected in United States
    2. Age over 60 years: 3 to 6%
    3. Age over 70 years: 10 to 18%
  4. Risk Factors
    1. Age over 60 (Odds ratio 4.1)
    2. Cerebrovascular Disease (Odds ratio 3.6)
    3. Coronary Artery Disease (Odds ratio 3.5)
    4. Diabetes Mellitus (Odds ratio 2.5)
    5. Hypercholesterolemia (Odds ratio 1.9)
    6. Tobacco abuse (risk persists >5 years after cessation)
      1. Cigarette smoking 20 per day: 2.11 relative risk
      2. Cigarette smoking 11-20 per day: 1.75 relative risk
    7. Systolic Hypertension
    8. Hyperhomocysteinemia
    9. Increased Body Mass Index (Obesity)
    10. C-Reactive Protein increased
    11. Chronic Kidney Disease with GFR rate <60 ml/min/1.73m2
  5. Associated Conditions
    1. Coronary Artery Disease (Myocardial Infarction)
    2. Carotid Stenosis (Cerebrovascular Accident)
  6. Symptoms
    1. Presentations
      1. Classic Claudication: 10% of cases
      2. Atypical Leg Pain: 50% of cases
      3. Asymptomatic: 40% of cases
    2. Classic Claudication
      1. Cramp-like leg muscle pain with Exercise, better with rest
        1. Calf pain typical (pain may occur in thigh, buttock)
      2. Pain worse with exertion
      3. Pain relieved within 10 minutes rest
      4. Pain relieved with rest and dependent position
    3. Critical Limb Ischemia (1% of presentations)
      1. Tissue loss or gangrene
      2. Chronic rest pain
    4. Timing of symptoms related to degree of stenosis
      1. Exertional pain: 70% arterial pain
      2. Nocturnal pain: 70 to 90% arterial stenosis
      3. Ischemic rest pain: 90% arterial stenosis
  7. Exam
    1. Vascular Exam (Arterial Bruits or diminished pulses)
      1. Abdominal aorta bruit
      2. Femoral artery pulse
      3. Dorsalis pedis pulse (absent in up to 3% of normal patients)
      4. Posterior tibial pulse
      5. Carotid Artery pulse and bruit (for comorbid Carotid Stenosis)
    2. Neurologic Exam
      1. Critical in determining Acute Limb Ischemia degree (see Rutherford Classification below)
      2. Extremity Motor Exam
      3. Extremity Sensory Exam
  8. Signs
    1. Most reliable signs of Peripheral Vascular Disease (Sensitivity, Specificity assumes ABI<0.9)
      1. Posterior tibial artery doppler Ultrasound
        1. All 3 components present rules-out Peripheral Arterial Disease
        2. Only 1 of 3 components present is strongly suggestive of PAD (Positive Likelihood Ratio = 7.0)
      2. Dorsalis pedis AND posterior tibial pulse absent
        1. Test Sensitivity: 63%
        2. Test Specificity: 99%
      3. Femoral artery bruit
        1. Test Sensitivity: 29%
        2. Test Specificity: 95%
      4. Atypical Skin Color (pale, red, blue) of extremity
        1. Test Sensitivity: 35%
        2. Test Specificity: 87%
    2. Local Signs of Peripheral Vascular Disease
      1. Dry, scaly, shiny atrophic skin
      2. Skin hairless over lower extremity (e.g. shin)
      3. Dystrophic, brittle Toenails
      4. Non-healing ulcers or other lower extremity wounds
      5. Decreased skin Temperature (cool feet)
      6. Decreased Capillary Refill Time
      7. Distal extremity color change with position
        1. Skin rubor when leg dependent
        2. Skin pallor when leg elevated >1 minute
          1. Color returns within 15 seconds in mild cases
          2. Delay >40 seconds suggests severe ischemia
  9. Signs: Acute Limb Ischemia (5 P's)
    1. Early finding
      1. Pain
    2. Late findins
      1. Pulselessness
      2. Pallor
      3. Paresthesias
      4. Paralysis
  10. Signs: Occlusion Location
    1. Inflow Disease: Aortoilliac Occlusive Disease
      1. Also known as Leriche's Syndrome
      2. Bilateral leg diminished pulses throughout
      3. Slow Wound Healing legs
      4. Impotence
    2. Outflow Disease
      1. Iliofemoral Occlusive Disease
        1. Unilateral leg diminished pulses throughout
        2. Buttock Claudication may be present
      2. Femoropopliteal Occlusive Disease
        1. Thigh and calf Claudication
        2. Normal femoral pulses in groin
  11. Classification
    1. Rutherford Classification of Acute Limb Ischemia
      1. Category I: Viable (no immediate threat)
        1. No sensory deficit
        2. No motor deficit
        3. Arterial doppler audible but typically monophasic (but venous doppler audible)
      2. Category IIA: Marginally threatened (salvageable if promptly treated)
        1. Minimal sensory deficit (e.g. toes involved)
        2. No motor deficit
        3. Arterial doppler inaudible (but venous doppler audible)
      3. Category IIB: Immediately Threatened (salvageable if immediately revascularized)
        1. Sensory deficit with rest pain
        2. Mild to moderate motor deficit
        3. Arterial doppler inaudible (but venous doppler audible)
      4. Category III: Irreversible (major tissue loss with permanent nerve injury)
        1. Severe sensory deficit with complete anesthesia
        2. Severe motor deficit with paralysis or rigor
        3. Arterial doppler inaudible (but venous doppler audible)
    2. Fontaine Stage
      1. Stage I: Asymptomatic
        1. Ankle-Brachial Index < 0.9
        2. Decreased distal pulses
      2. Stage II: Intermittent Claudication
      3. Stage III: Daily rest pain
      4. Stage IV: Focal tissue necrosis (non-healing ulcers)
        1. Ankle-Brachial Index < 0.3 (50% block)
    3. Grading Claudication
      1. Initial Claudication Distance
        1. Distance patient first experiences exertional pain
      2. Absolute Claudication Distance
        1. Furthest distance patient is able to walk
  12. Differential Diagnosis
    1. See Leg Pain
    2. See Hip Pain
    3. See Knee Pain
    4. See Foot Pain
    5. Common and important other Leg Pain causes
      1. Lumbar Spinal Stenosis (Pseudoclaudication)
      2. Peripheral Neuropathy (e.g. Diabetic Neuropathy)
      3. Nerve Entrapment (e.g. Meralgia Paresthetica, Posterior Tarsal Tunnel Syndrome)
      4. Night Cramps
      5. Exertional Compartment Syndrome (or Chronic Compartment Syndrome)
      6. Stress Fracture
      7. Arthritis
      8. Intermittent Claudication (Peripheral Vascular Disease)
      9. Deep Vein Thrombosis (DVT)
      10. Venous Insufficiency
    6. Acute Limb Ischemia differential diagnosis
      1. Congestive Heart Failure with superimposed PVD
        1. Identical presentation to limb ischemia
      2. Deep Venous Thrombosis
        1. Blue extremity without pallor
        2. Swollen, painful extremity
      3. Acute spinal cord compression
        1. Skin Color normal
        2. Limb paralysis with pain and Paresthesias
    7. Acute Limb Ischemia sites of compromise proximal to extremity
      1. Thoracic Aortic Dissection
      2. Abdominal Aortic Aneurysm (AAA)
      3. Embolic phenomenon from a cardiac source
  13. Labs
    1. Complete Blood Count with platelets
    2. Lipid profile
    3. Serum Homocysteine
    4. Apolipoprotein A
    5. Serum Creatinine
    6. Hemoglobin A1C or Fasting Serum Glucose
    7. Urinalysis for glucosuria or Proteinuria
    8. Consider screening for Hypercoagulability
  14. Diagnosis
    1. See Edinburgh Claudication Questionnaire
    2. See PAD Score
    3. See Segmental Arterial Pressure
    4. See Ankle-Brachial Index
      1. ABI is the vital sign of Peripheral Arterial Disease
      2. Obtain for diagnosis and monitor periodically for disease progression
      3. Ankle-Brachial Ratio >1.3: Non-compressable vessels (false negative)
      4. Ankle-Brachial Ratio >0.95: Normal
      5. Ankle-Brachial Ratio <0.5: Severe, multi-level disease
      6. Ankle-Brachial Ratio <0.3: Limb Threatening Ischemia (requires emergent intervention)
      7. Ankle-Brachial Ratio <0.2: Gangrenous extremity
  15. Screening: Indications with Ankle-Brachial Index
    1. Guidelines vary per organization
      1. USPTF does not recommend routine screening unless symptomatic (e.g. exertional Leg Pain or non-healing distal extremity wounds)
      2. However, Cardiovascular Risk Reduction even in the absence of diagnosis will benefit PAD in addition to other vascular disease
    2. Diabetes Mellitus (ADA, ACC/AHA)
      1. Start at age 50 years or earlier if other comorbid PAD Risk Factors (e.g. Tobacco abuse, Hyperlipidemia, Diabetes Mellitus >10 years)
      2. Repeat every 5 years
    3. Age over 65 years old (ACC/AHA)
    4. Framingham Score >10-20% (TASC)
  16. Grading
    1. History
      1. Degree of extremity pain
      2. Pain-free walking distance
    2. Questionaires (e.g. Walking Impairment Questionaire)
    3. Treadmill testing
      1. Maximal walking distance
      2. Pain-free walking distance
  17. Course
    1. Typical course of non-critical ischemia
      1. Claudication remains stable in 80% of patients
      2. Five year risk of Claudication worsening: 16%
      3. Claudication requiring surgery: 25%
    2. Risk of limb loss (amputation)
      1. Stable non-critical ischemia
        1. Risk at five years: 4-7%
        2. Risk at ten years: 12%
      2. Critical Limb Ischemia
        1. Risk at 6-12 months from onset: 80-90%
    3. Five year Mortality from atherosclerotic cause: 29%
      1. Coronary Artery Disease deaths: 60%
      2. Cerebrovascular Accident related deaths: 15%
    4. Overall survival
      1. Survival at ten years: 38%
      2. Survival at fifteen years: 22%
  18. Management: Acute Limb Ischemia (Emergency management)
    1. Precaution: Rapid evaluation and management is critical
      1. Irreversible neuromuscular damage occurs within 6 hours
      2. Involve intervention radiology and vascular surgery early in suspected Acute Limb Ischemia
    2. Evaluation
      1. Focused history and exam as above
      2. Ankle-Brachial Index <0.3 (or <0.5 with other findings suggestive of Acute Limb Ischemia)
      3. Assign Rutherford Classification (see above)
    3. Medications
      1. Aspirin 325 mg orally
      2. Unfractionated Heparin
    4. Emergent surgical interventions
      1. Intervention radiology for directed arterial Thrombolysis or percutaneous thrombectomy
        1. Indicated for Rutherford Class I and IIa (see above)
      2. Vascular surgery
        1. Indicated for Rutherford Class IIb and III (see above)
    5. References
      1. Lin in Herbert (2014) EM:Rap 14(4): 5-7
  19. Management: Chronic Claudication
    1. See Claudication Management
    2. Cardiovascular Risk Reduction is critical
      1. Carries same risk as Coronary Artery Disease
  20. Resources
    1. Vascular Disease Foundation
      1. http://www.vdf.org
  21. References
    1. Boccalon (1999) Drugs Aging 14:247
    2. Boyd (1962) Proc R Soc Med 55:591-96
    3. Carman (2000) Am Fam Physician 61(4):1027-32
    4. Gardner (1995) JAMA 274(12):975-80
    5. Gey (2004) Am Fam Physician 69:525-33
    6. Hennion (2013) Am Fam Physician 88(5): 306-10
    7. Hirsch (2001) JAMA 286(11):1317-24
    8. Imparato (1975) Surgery 78:795-9
    9. Samuelson (March, 2000) Fed Pract, p. 34-50
    10. Santilli (1999) Am Fam Physician 59(7):1899-908
    11. Santilli (1996) Am Fam Physician 53(4):1245-53
    12. Sontheimer (2006) Am Fam Physician 73(11):1971-6
    13. (1999) Med Lett Drugs Ther 41:(1052):44-6

Arterial insufficiency (C0003834)

Concepts Disease or Syndrome (T047)
SnomedCT 195374003
English ARTERIAL INSUFFICIENCY, arterial insufficiency, arterial insufficiency (diagnosis), arterial insufficiencies, Arterial insufficiency, Arterial insufficiency (disorder), insufficiency; arterial, artery; insufficiency
Italian Insufficienza arteriosa
Japanese 動脈不全, ドウミャクフゼン
Czech Arteriální nedostatečnost
Hungarian Arteriás elégtelenség
Dutch arterie; insufficiëntie, insufficiëntie; arteria, arteriële insufficiëntie
Spanish insuficiencia arterial (trastorno), insuficiencia arterial, Insuficiencia arterial
Portuguese Insuficiência arterial
French Insuffisance artérielle
German arterielle Insuffizienz
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Intermittent Claudication (C0021775)

Definition (MSH) A symptom complex characterized by pain and weakness in SKELETAL MUSCLE group associated with exercise, such as leg pain and weakness brought on by walking. Such muscle limpness disappears after a brief rest and is often relates to arterial STENOSIS; muscle ISCHEMIA; and accumulation of LACTATE.
Concepts Disease or Syndrome (T047)
MSH D007383
ICD10 I73.9
SnomedCT 195312007, 155430009, 63491006
French CLAUDICATION INTERMITTENTE, Myasthénie angiosclérotique, Maladie de Charcot, Claudication intermittente
English CLAUDICATION INTERMITTENT, Claudication, Intermittent, INTERMITTENT CLAUDICATION, Intermittent Claudication, intermittent claudication, intermittent claudication (diagnosis), Claudication (& [intermittent]) (disorder), Claudication intermittent, Intermittent Claudication [Disease/Finding], Claudication;intermittent, claudication intermittent, charcot's syndrome, intermittent claudications, Angiosclerotic myasthenia, Charcot's syndrome, Intermittent claudication, Myasthenia angiosclerotica, IC - Intermittent claudication, Intermittent claudication (disorder), claudication, intermittent, Charcot; syndrome, syndrome; Charcot, Claudication (& [intermittent]), Intermittent claudication NOS
Portuguese CLAUDICACAO INTERMITENTE, Síndrome de Charcot, Miastenia angiosclerótica, Claudicação intermitente, Claudicação Intermitente
Spanish CLAUDICACION INTERMITENTE, Síndrome de Charcot, Miastenia angiosclerótica, Intermittent claudication, Claudication (& [intermittent]), claudicación intermitente (trastorno), claudicación intermitente, miastenia angioesclerótica, síndrome de Charcot, Claudicación intermitente, Claudicación Intermitente, Claudicacion Intermitente
German CLAUDICATIO INTERMITTENS, angiosklerotische Myasthenie, Charcot-Syndrom, Claudicatio intermittens
Dutch angiosclerotische myasthenie, claudicatio intermittens, syndroom van Charcot, Charcot; syndroom, syndroom; Charcot, intermitterende claudicatio, Claudicatio intermittens
Italian Sindrome di Charcot, Miastenia angiosclerotica, Claudicazione intermittente
Japanese 動脈硬化性筋無力症, 間欠性跛行, シャルコー症候群, ドウミャクコウカセイキンムリョクショウ, カンケツセイハコウ, シャルコーショウコウグン
Swedish Fönstertittarsjuka
Czech intermitentní klaudikace, Intermitentní klaudikace, Angiosklerotická myastenie, Charcotův syndrom
Finnish Katkokävely
Russian PEREMEZHAIUSHCHAIASIA KHROMOTA, KHROMOTA PEREMEZHAIUSHCHAIASIA, ПЕРЕМЕЖАЮЩАЯСЯ ХРОМОТА, ХРОМОТА ПЕРЕМЕЖАЮЩАЯСЯ
Polish Chromanie przestankowe
Hungarian Angiosclerotikus myasthenia, Charcot-syndroma, Claudicatio intermittens
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Leriche Syndrome (C0023370)

Definition (MSH) A condition caused by occlusion of terminal aorta, the primary branches of the ABDOMINAL AORTA, as in aortoiliac obstruction. Leriche syndrome usually occurs in males and is characterized by IMPOTENCE, absence of a pulse in the femoral arteries, weakness and numbness in the lower back, buttocks, hips, and lower limbs.
Concepts Disease or Syndrome (T047)
MSH D007925
ICD9 444.01
ICD10 I74.0
SnomedCT 56336009, 307816004, 233972005, 37778000, 195316005
English Chronic aorto-iliac occlusion syndrome, Leriches Syndrome, Syndrome, Leriche's, AORTIC BIFURCATION SYNDROME, ACUTE, AORTIC BIFURCATION SYNDROME, CHRONIC, EMBOLISM, AORTIC BIFURCATION, EMBOLISM, AORTIC, SADDLE, LERICHE SYNDROME, Aortic bifurcation thrombosis syndrome, Saddle embolus of aorta syndrome, AORTIC OCCLUSION DISTAL CHRONIC, Syndrome, Leriche, Leriche's Syndrome, saddle embolus of abdominal aorta (diagnosis), saddle embolus of abdominal aorta, Leriche syndrome (diagnosis), Aortic bifurcation syndrome (disorder), Saddle embolus of aorta, Leriche syndrome, Leriche Syndrome [Disease/Finding], leriches syndrome, leriche syndrome, syndrome leriche, leriche's syndrome, Saddle embolus abd aorta, Leriche Syndrome, Leriche's syndrome, Aortic bifurcation syndrome, Aortoiliac obstruction, Saddle embolus of abdominal aorta, Aortic bifurcation embolus, Saddle embolus, Leriche's syndrome (disorder), Aortic bifurcation embolus (disorder), Saddle embolus (morphologic abnormality), bifurcation; aortic, syndrome, Leriche, embolism; aortic, bifurcation, embolism; aortic, saddle, saddle embolus; aorta, syndrome; aortic bifurcation, thrombosis; aortic, bifurcation, aorta; bifurcation, syndrome, aorta; embolism, bifurcation, aorta; embolism, saddle, aorta; saddle embolus, aorta; thrombosis, bifurcation, aortic bifurcation; syndrome, Aortic bifurcation syndrome (disorder) [Ambiguous]
Dutch ruiterembolie van de aorta, aorta; bifurcatie, syndroom, aorta; embolie, bifurcatie, aorta; embolie, ruiter, aorta; trombose, bifurcatie, aorta; zadel-embolus, aortabifurcatie; syndroom, bifurcatie; aorta, syndroom, embolie; aorta, bifurcatie, embolie; aorta, ruiter, syndroom; aortabifurcatie, trombose; aorta, bifurcatie, zadel-embolus; aorta, Leriche-syndroom, Syndroom, Leriche-
French Embole aortique en selle, Syndrome de Leriche
German reitender Aortenembolus, Leriche Syndrom, Aortenbifurkationssyndrom, Leriche-Syndrom
Italian Embolo aortico a sella, Sindrome di Leriche
Portuguese Êmbolo em sela da aorta, Síndrome de Lériche, Síndrome de Leriche
Spanish Émbolo cabalgante de aorta, Leriche's syndrome, Aortic bifurcation syndrome, Saddle embolus, Aortoiliac obstruction, obstrucción aortoilíaca (trastorno), obstrucción aortoilíaca, síndrome de Leriche (concepto no activo), síndrome de Leriche (trastorno), síndrome de Leriche, síndrome de bifurcación aórtica, síndrome de la bifurcación aórtica, émbolo de aorta abdominal en silla de montar, émbolo en silla de montar (anomalía morfológica), émbolo en silla de montar de la aorta abdominal, émbolo en silla de montar, Sindrome de Leriche, Síndrome de Leriche
Japanese 大動脈鞍状塞栓, ルリーシュショウコウグン, ダイドウミャクアンジョウソクセン, Leriche症候群, ルリッシュ症候群, ルリーシュ症候群, レリシュ症候群, 血栓性大動脈分岐部閉塞症
Swedish Leriches syndrom
Czech Lericheův syndrom, Lerichův syndrom, Sedlovitý embolus v aortě
Finnish Lerichen oireyhtymä
Russian LERISHA SINDROM, ЛЕРИША СИНДРОМ
Croatian LERICHEOV SINDROM
Polish Zespół Leriche'a, Niedrożność aortalno-biodrowa
Hungarian Leriche-syndroma, Aorta lovagló embolusa
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Peripheral Vascular Diseases (C0085096)

Definition (NCI) Any disorder affecting blood flow through the veins or arteries outside of the heart.
Definition (CSP) condition in which there is a deviation from or interruption of the normal structure or function of the blood vessels outside the heart; diseases of the peripheral as opposed to the cardiac circulation.
Definition (MSH) Pathological processes involving any one of the BLOOD VESSELS in the vasculature outside the HEART.
Concepts Disease or Syndrome (T047)
MSH D016491
ICD9 443.9
ICD10 I73.9
SnomedCT 155431008, 266320008, 195314008, 195311000, 400047006, 399957001, 91523003, 155433006, 266321007
English Angiopathies, Peripheral, Disease, Peripheral Vascular, Diseases, Peripheral Vascular, Peripheral Angiopathies, Peripheral Angiopathy, Vascular Disease, Peripheral, Vascular Diseases, Peripheral, PERIPHERAL VASCULAR DISORDER, peripheral blood vessel disorder, Angiopathy, Peripheral, DISORDER PERIPHERAL VASCULAR, DISORDER VASCULAR PERIPHERAL, PERIPHERAL VASCULAR DISEASE, VASCULAR DISORDER PERIPHERAL, Peripheral angiopathy, NOS, Peripheral vascular disease, NOS, Peripheral vascular diseases, PVD - Periph vascular disease, Peripheral vasc.disease NOS, Peripheral vascular disease NOS, Peripheral vascular disease, unspecified, PERIPHERAL VASCULAR DISORDER NOS, PERIPHERAL VASCULAR DIS, VASCULAR DIS PERIPHERAL, DIS PERIPHERAL VASCULAR, peripheral vascular disease (diagnosis), PVD (peripheral vascular disease), peripheral vascular disease, pvd, Peripheral vascular disease (& [NOS]) (disorder), Peripheral vascular disease NOS (disorder), Circulatory disorder peripheral, Disorder peripheral vascular, Disorder vascular peripheral, Peripheral vascular disorder NOS, Vascular disorder peripheral, VASCULAR DISEASE PERIPHERAL, Peripheral Vascular Disease, Periph vascular dis NOS, Peripheral vascular disease unspecified, VASCULAR DISEASE, PERIPHERAL, DISEASE, PERIPHERAL VASCULAR, Peripheral angiopathy NOS, Peripheral Vascular Diseases [Disease/Finding], peripheral arterial disease, arterial diseases peripheral, peripheral vascular disorder, Disease;peripheral vascular, circulatory disorders peripheral, pvds, circulatory disorder peripheral, peripheral angiopathy, peripheral vascular disease (PVD), peripheral vascular diseases, Peripheral Vascular Diseases, Peripheral vascular disorder, Peripheral vascular disease, PVD - Peripheral vascular disease, Peripheral angiopathy, Peripheral vascular disease (disorder), PVD-peripheral vascular disease, disease (or disorder); peripheral, vascular, peripheral; angiopathy, angiopathy; peripheral, Peripheral vasc. disease NOS, Peripheral vascular dis. NOS, Peripheral vascular disease (& [NOS]), Vasc. dis. periph. NOS, Peripheral Vascular Disorder, peripheral angiopathies
French MALADIE VASCULAIRE PERIPHERIQUE, Trouble de la circulation périphérique, Affection des vaisseaux périphériques, Maladie vasculaire périphérique SAI, Maladie vasculaire périphérique, non précisée, Trouble des vaisseaux périphériques, Trouble vasculaire périphérique SAI, Maladie vasculaire périphérique, AFFECTIONS VASCULAIRES PERIPH, Trouble vasculaire périphérique, Angiopathies périphériques, Maladies vasculaires périphériques, Vasculopathies périphériques
Italian Disturbo vascolare periferico, Disturbo vascolare periferico NAS, Patologia vascolare periferica, Malattia vascolare periferica NAS, Disturbo circolatorio periferico, Malattia vascolare periferica, Malattia vascolare periferica non specificata, Angiopatie periferiche, Malattie dei vasi periferici
Dutch perifere circulatoire aandoening, perifere vasculaire ziekte NAO, niet-gespecificeerde perifere vasculaire ziekte, perifere vasculaire aandoening NAO, perifere vasculaire ziekte, aandoening perifeer vasculair, aandoening vasculair perifeer, vasculaire aandoening perifeer, aandoening; perifeer, vasculair, angiopathie; perifeer, perifeer; angiopathie, Perifere vaatziekte, niet gespecificeerd, perifere vasculaire aandoening, Perifere angiopathie, Perifere vaatziekte, Perifere vaatziekten, Vaatziekten, perifere, Ziekte, perifere vaat-, Ziekten, vaat-, perifere
German Kreislauferkrankung peripher, periphere Gefaesserkrankung NNB, Periphere Gefaesserkrankungen NNB, periphere Gefaesserkrankung, unspezifisch, Gefaesserkrankung peripher, GEFAESSERKRANKUNG PERIPHER, PERIPHERE GEFAESSVERAENDERUNGEN N, Periphere Gefaesskrankheit, nicht naeher bezeichnet, periphere Gefaesserkrankung, Periphere Angiopathien, Periphere Gefäßkrankheiten, Vaskuläre Krankheiten, periphere
Portuguese Afecção vascular periferal NE, Vasculopatia periférica NE, Afecção vascular periférica, Afecção circulatória periférica, Vasculopatia periférica, DOENCA VASCULAR PERIFERICA NE, DOENCA VASCULAR PERIFERICA, Doenças Arteriais Periféricas, Anomalia vascular periférica, Angiopatias Periféricas, Doenças Vasculares Periféricas
Spanish Enfermedad vascular periférica NEOM, Enfermedad vascular periférica no especificada, Enfermedad vascular periférica, Trastorno vascular periférico NEOM, Trastorno circulatorio periférico, Peripheral vasc. disease NOS, Peripheral vascular disease NOS, Peripheral vascular disease, Peripheral vascular disease (& [NOS]), Peripheral vascular dis. NOS, Vasc. dis. periph. NOS, VASCULAR PERIFERICA, ENFERMEDAD, Enfermedades Arteriales Periféricas, Enfermedades Arteriales Perifericas, angiopatía periférica, enfermedad vascular periférica (trastorno), enfermedad vascular periférica, SAI, enfermedad vascular periférica, vasculopatía periférica (trastorno), vasculopatía periférica, SAI (trastorno), vasculopatía periférica, SAI, vasculopatía periférica, Trastorno vascular periférico, Angiopatías Periféricas, Enfermedades Vasculares Periféricas, Angiopatias Perifericas, Enfermedades Vasculares Perifericas
Japanese 末梢血管疾患、詳細不明, 末梢血管障害NOS, 末梢血管疾患NOS, 末梢血管障害, マッショウケッカンシッカンNOS, マッショウケッカンショウガイ, マッショウケッカンシッカン, マッショウケッカンシッカンショウサイフメイ, マッショウジュンカンショウガイ, マッショウケッカンショウガイNOS, 末梢血管疾患, 血管疾患-末梢, 末梢血管症, 循環障害-末梢, 末梢循環障害
Swedish Perifera kärlsjukdomar
Czech periferní angiopatie, Porucha periferního oběhu, Periferní cévní choroba, blíže neurčená, Periferní cévní porucha, Periferní cévní choroba NOS, Periferní cévní porucha NOS, Periferní cévní choroba, cévy periferní - nemoci, onemocnění periferních cév
Finnish Ääreisverisuonten taudit
Russian KROVENOSNYKH SOSUDOV PERIFERICHESKIKH BOLEZNI, ANGIOPATIIA PERIFERICHESKAIA, SOSUDISTYE BOLEZNI PERIFERICHESKIE, АНГИОПАТИЯ ПЕРИФЕРИЧЕСКАЯ, КРОВЕНОСНЫХ СОСУДОВ ПЕРИФЕРИЧЕСКИХ БОЛЕЗНИ, СОСУДИСТЫЕ БОЛЕЗНИ ПЕРИФЕРИЧЕСКИЕ
Korean 상세불명의 말초혈관 질환
Croatian VASKULARNE BOLESTI, PERIFERNE
Polish Angiopatie obwodowe, Choroby naczyń obwodowych
Hungarian Vascularis peripheriás betegség, Peripheriás érbetegség k.m.n., Környéki ér eredetű betegség k.m.n., Betegség, peripheriás vascularis, Peripheriás vascularis betegség, Peripheriás érbetegség, Peripheriás ér eredetű betegség, Keringési elégtelenség, periphériás, Peripheriás vascularis kór, nem meghatározott
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Iliac artery stenosis (C0729847)

Concepts Anatomical Abnormality (T190)
SnomedCT 312496009
Italian Stenosi dell'arteria iliaca
Japanese 腸骨動脈狭窄, チョウコツドウミャクキョウサク
English iliac artery stenosis (diagnosis), iliac artery stenosis, Iliac artery stenosis, Iliac artery stenosis (disorder)
Czech Stenóza arteria iliaca
Hungarian Arteria iliaca stenosis
Spanish estenosis de arteria ilíaca (trastorno), estenosis de arteria ilíaca, Estenosis de las arterias iliacas
Portuguese Estenose da artéria ilíaca
Dutch arteria iliaca stenose
French Sténose de l'artère iliaque
German Stenose der arteria iliaca
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Femoral arterial stenosis (C0853255)

Concepts Pathologic Function (T046)
Italian Stenosi di arteria femorale, Stenosi dell'arteria femorale
German Stenose der Femoralarterie, Stenose der Arteria femoralis
Japanese 大腿動脈狭窄, ダイタイドウミャクキョウサク
Czech Stenóza stehenní tepny, Stenóza arteria femoralis
English Femoral arterial stenosis, Femoral artery stenosis
Hungarian Arteria femoralis stenosis, Arteria femoralis stenosisa
Portuguese Estenose da artéria femoral
Spanish Estenosis de la arteria femoral
Dutch arteria femoralis stenose
French Sténose de l'artère fémorale
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Critical limb ischemia (C1142264)

Concepts Pathologic Function (T046)
Dutch ischemie in kritieke ledemaat
German kritische Ischaemie einer Extremitaet, kritische Ischaemie von Gliedmassen
Italian Ischemia critica degli arti
Portuguese Isquemia crítica do membro
Spanish Isquemia crítica en un miembro, Isquemia crítica de miembro
Japanese 重症虚血肢, ジュウショウキョケツシ
French Ischémie critique d'un membre
Czech Kritická končetinová ischemie, Kritická ischemie končetin
English critical ischemia limb, critical limb ischemia, critical limb ischaemia, Critical limb ischaemia, Critical limb ischemia
Hungarian Kritikus végtagi ischaemia, Kritikus végtag ischaemia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Claudication (finding) (C1456822)

Definition (NCI) Limping or lameness.
Definition (CSP) limping or lameness.
Concepts Disease or Syndrome (T047)
SnomedCT 275520000, 16973004, 195312007
English LEG PAIN WITH WALKING, LOWER EXTREMITY EXERTIONAL PAIN, Lameness, Limping, Claudication (finding), claudication, LOWER EXTREMITY PAIN WALKING, CLAUDICATION, Claudication
Dutch claudicatio
French Claudication
German Claudicatio
Italian Claudicazione
Portuguese Claudicação
Spanish Claudicación, Claudication, claudicación (hallazgo), claudicación
Japanese 跛行, ハコウ
Czech Klaudikace
Hungarian Claudicatio
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Femoropopliteal stenosis (C2721556)

Concepts Pathologic Function (T046)
English Femoropopliteal stenosis
Spanish Estenosis femoropoplítea
Portuguese Estenose femoropoplítea
French Sténose fémoro-poplitée
Italian Stenosi femoro-popliteale
German Femoropopliteale Stenose
Dutch femoropopliteale stenose
Czech Femoropopliteální stenóza
Japanese 大腿膝窩動脈狭窄, ダイタイシッカドウミャクキョウサク, ダイタイシツカドウミャクキョウサク
Hungarian Femoro-poplitealis stenosis
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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