Subject Index

Acetyl salicylic acid 64,100,106 Batroxobin 104 Acute limb ischaemia 19 Betablockers 41,46 Adenosine diphosphate (ADP) 100 Beta-thromboglobulin 28 p-Adrenoceptor agonists 106 Bifurcated graft 73 Albumin 105 Blebs 35 Alteplase, see tissue-type plasminogen Blood glucose 154 activator Blood rheology 30 Amputation Blood sugar levels 152 aetiology 88 blood tests 41 healing rate 97 Brinase 103,109 incidence 10,15,87 Buflomedil 84,97,111 indications 89,91 investigation of patients prior to 90 level of 92, 96 Calcium-antagonists 46 rates 10,15,89,96 Capillaroscopy 151 rates in diabetics 153 Capillary density 23 versus limb salvage 91 Cardiac emboli 19 Ancrod 104,109,115 Cardiac failure 25 Angiography 42,50,76,90,151 Cardiac status 20 digital subtraction 50 Cardiovascular mortality 15 Angiotensin-converting enzyme Carotid arteries 41 inhibitors 46 Catecholamine release Anistreplase 103 inhibition of 120 Ankle pressure 8,20 Cellulitis 160 Antibiotics 46,158 Cephalic vein 75 Anticoagulants 29,65,102,107,153 Cholesterol 26 Antithrombin 101 Coagulation factors 100,102 Antithrombin III 29, 101 Collagen 100 Anti-platelet drugs 28,64, 100, 106, 114, Collateral vessels 39 153 Consensus Document II 163 Anxiety 2 Consensus process 163 Aorto Iliac Disease 72 Coronary artery bypass 50 APSAC, see anistreplase 103 Coronary heart disease 45 Arterial pressure 111 Coumarin 102 Arterial spasm 21 Critical closing pressure 45 Artificial grafts 74, 77 Critical ischaemia Aspirin, see Acetyl salicylic acid assessment 41 Atherogenesis 20 biochemical factors 25 Axillo bifemoral grafts 73 clinical trial guidelines 167 170 Sachverzeichnis

Critical ischaemia Factor VIII 28 definition 7,9,71,130 Factor Xa 101 epidemiology 10 Fahraeus effect 30 general management 41 Fahraeus-Lindqvist effect 30 haemodynamics 19 Fahraeus-Vejlens effect 31 incidence 10,11,163 Femoro distal procedures 75 investigation 41 Femoro-popliteal disease 74 management policy 165 Fibrin 28 pathophysiology 17, 34, 39 Fibrinogen 28, 29, 100 prognosis 12,41 Fibrinolysis Cross over graft 55,72,73 local 53,63 Crural vessel 75 Fibrinolytic agents 63 Fibronectin 100 Fluorescein angiography 23 Deep vein thrombosis 25 Fogarty catheters 73 Defibrinogenating agents 104, 109 Fontaine Denial 2 classification 8,9,71 Dependency of the feet 20 Footcare 47 Depression 2,3 Fraciparin 107 Dextran 104,110,115 Diabetes mellitus control of 154 Glycoproteins 100 incidence 146 Graft occlusion 79 prevalence 146 Graft surveillance 79 Diabetic foot clinic 160 Haematocrit 30 investigation 151, 159 Haemodilution management 152, 158, 160 normovolaemic 104,110 Diabetic osteopathy 150 Haemodynamics 18 Diabetic patient Haemoglobin 31 and critical ischaemia 11 Haemometakinesia 39 biochemical changes in 25 Heart 19 dyslipoproteinaemia in 147 Heparin 65,101,107,114 incidence of critical Hirudin 102, 108 ischaemia in 14 Hyaluronidase 109 metabolic control of 154 Hydroxyethyl starch (HES) 105 mortality 15 Hyperbaric oxygen 105, 11 0 Diabetic ulcers Hyperglycaemia 146,148 management 152 Hyperinsulinaemia 147 Dipyridamole 64, 107 Hypertension 45 Distal anastomoses 76 in diabetes 147 Diuretics 47 Hypertriglyceridaemia Doppler ankle/arm pressure index 21 in diabetes 147 Doppler sonography 151 Drug treatment 41 Duplex scanning 44, 79 Iliac disease 73 Dynamic angioplasty 59 Iliac occlusion unilateral 73 Iliac occlusions 73 Elevation test 42 bilateral 73 Endothelium 26 Iloprost Endothelium-derived constricting factor clinical trials in critical ischaemia 128 (EDCF) 26 cytoprotective effect 121 Endothelium-derived growth factor inhibition ofleukocyte activity 119 (EDGF) 26 profibrinolytic effect 120 Endothelium-derived relaxant factor protective effect on vascular endothelium (EDRF) 26,27 119 Exercise ECG 50 vasodilatory activity 119 Sachverzeichnis 171

Indanedione 102 Pain 2 Infection 46,150,159 Pallor on elevation 23 Interleukin-l 29 Papaverine test 73 Intermittent claudication 21 Pentoxifylline 84,97, 11 L Intimal hyperplasia 75 Percutaneous atherectomy 59,65 Percutaneous embolectomy 59 Percutaneous translurninal angioplasty, see Kaltenbach-Vall bracht-rotating PTA catheter 65 Peripheral neuropathy 146 Kensey-catheter 65 Peripheral resistance 77 Ketanserin 107, 111 PGE 1, see Prostaglandin E 1 Kissing-balloon method 57 Pharmacological prophylaxis 64 Pharmacotherapy 99,153 Photoplethysmography 93 Laboratory investigations 42 Placebo effect 132 Laser angioplasty 59,65 Plasma viscosity 104 Laser Doppler flowmetry 93, 158 Plasmatic capillaries 23 Laser-Doppler flux measurement 24,44, Plasmin 103 151 Plasminogen 103 Leeches 25 Plasminogen activator inhibitor type 1, Leucocytes 29,30,119 (PAI-1) 26 Limb fitting centres 88 Pilltelet activating factor (P AF) 29 Lipid Peroxides 26 Platelet activation 21 Lipids 26 Platelet refractoriness 118 Low density lipoproteins 26 Platelets 27,100 Popliteal aneurysm 70 Pressure index 158, 160 Preventive treatment Macroangiopathy 146 in diabetics 153 Magnetic resonance spectroscopy 93 Prostacyclin (PGI ) 26,27,64,96 Microangiopathy 146, 159 2 clinical studies in critical ischaemia 125 Microcirculation 18,21,43 mechanism of action 117 Microcirculatory blood flow 23,24, 35, Prostaglandin El (PGE 1) 139 clinical results in critical ischaemia 122 Microvascular defence system (MDS) 32 mechanism of action 117 Microvascular flow regulating system Prostanoids 28, 30, 84, 85,97 (MFRS) 32 antiplatelet activity 118 Mineralocortisteroids 111 clinical use 117 Monocytes 29 cytoprotective effect 121 Mortality rate 10 inhibition of catecholamine release 120 Multidisciplinaryapproach 166 inhibition ofleukocyte activity 119 Multilevel disease 39,69,72,78 interference with intimal proliferation of smooth muscle cells 121 mechanism of action 117 Naftidrofuryl 84,97, 111 "profibrinolytic" effect 120 Neuroarthropathy 150 protective effect on vascular Neuroischaemic ulcer 148, 150 endothelium 119 Neurological assessment 42 stimulatory effect of cholesterol-ester Neuropathic Ulcer 149,150 hydrolysis 121 Neutrophils 29 vasodilatoryactivity 119 Nifedipine 65 Protein C deficiency 25 Nitroglycerin 65 Pro-urokinase, see saruplase Psychological Considerations PTA Oedema 36,47 complication rates 59 Oscillography 42 contraindications 61 Oscillometric index 42 indications 59,70 172 Sachverzeichnis

PTA Sympathectomy limb salvage 62 chemical 80 limiting factors 61 surgical 80 prevention of reocclusion 64 results 61 technique 59 TcP02 44,93 PTFE 74 Thermal angioplasty 59 Pulmonary embolism 25 Thermography 93 Pulsating guide wire 65 Thrombin 101 Pulse generated run-off assessment Thromboangiitis obliterans 11,85,107, (p.G.R.) 77,90 127,130 Purpura fulminans 25 Thrombocythaemia 28 Thrombolysis local 63 Thrombolytic agents 103,108,114 Radioisotope clearance 93 ThromboxaneA2 100 Rehabilitation 5,92, 97 Ticlopidine 101,106 Revisional surgery 79 Tissue-type plasminogen activator Risk factors 20,39,41,146,153 (t-PA) 26,27,63,103,114 Rubor on dependency 23,31,50 Toe systolic blood pressure 9 Run off 43,59,90 Transcutaneous oxygen measurements, see (TcP02) Transcutaneous oxygen pressure 9,23 Triglyceride 26 Saphenous vein 74,77 Saruplase 103 Segmental blood pressure measurement umbilical vein 74 21,42 Urokinase 63,75,103,108,114 Serine proteases 101 Small vessel disease 149, 159 Smoking 44 Vasomotion 24, 40 in diabetes 147 Vasomotor paralysis 22 Sodium chloride supplements 111 Veins 25 Spasm Videodensitometry 23 prophylaxis 65 Videomicroscopy 23,40 Stents 59,65 Viscosity Streptokinase 63,75,103,108,114 plasma 30 Superoxide anions 29 Vital capillary microscopy 22,23,43 Surgical reconstruction Vitamin K 102 patency rates 72,73,75 Von Willebrand factor (vWF) 26, 27, 100