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1、CHAPTER63PERIPHERALARTERIALOCCLUSIVEDISEASEMichaelB.Silva,Jr.,LoriChoi,andCharlieC.ChengEPIDEMIOLOGYepidemiologyPeripheralarteryocclusivedisease(PAOD),commonlyreferredtobasicscienceofvasculardiseaseasperipheralarterialdisease(PAD)orperipheralvasculardiseaseevaluatingandt
2、reatingthepatientwithperipheral(PVD),referstotheobstructionordeteriorationofarteriesotherarterialdiseasethanthosesupplyingtheheartandwithinthebrain.Thereareothercausesofacuteandchroniclimbischemiaanumberofpathologicprocessesthatmanifesttheireffectsonrenalarterydiseasethe
3、arterialcirculation.splanchnicaneurysms:renal,mesenteric,andsplenicThecommondenominatoramongtheseprocessesisthearteryaneurysmsimpairmentofcirculationandresultantischemiatotheendcarotidarterydiseaseorganinvolved.Highlyprevalentinoursociety,arterialocclusivedisease,initsmy
4、riaditerations,constitutestheleadingoveralldialysisaccesscauseofdeath.Inadditiontodeathfrommyocardialinfarctionconclusionorstroke,significantdisabilityandlossoffunctionfromPADresultinanenormouscostinimpairedqualityoflifeforouragingpopulationandadirectfinancialcosttoourhe
5、althcaresystem.TheincidenceofsymptomaticPADincreaseswithage,Thespecialtyofvascularsurgeryhasmatureddramaticallyoverfromapproximately0.3%/yearformenaged40to55yearstothepastdecade.Withtheadventofnewdevicesandtechniquesapproximately1%/yearformenolderthan75years.Intheandthee
6、xpansionofcatheterandguidewireskills,themanage-UnitedStates,PADaffects12%to20%ofAmericansaged65mentofalmostallvascularpathologicprocesseshasbeenyearsandolder.undergoingaprocessofreevaluation.Surgeonshavetradition-PADismoreprevalentinnonwhitepopulations,andthisallybeencal
7、ledontomakediagnosesandmanagepatientswithisnotcompletelyexplainedbyanincreasedincidenceofcomor-1emergent,urgent,andelectivevascularsurgicalconditions.biddiseases.Anankle-brachialindex(ABI)lessthan0.90isAlthoughothermedicaldisciplinesareparticipatinginthisalmosttwiceascom
8、moninnon-Hispanicblacksthanwhites.processtoagreaterdegree,thesurgeonwithadvancedopenRiskisincreasedinsm
