paridheeya dhamani vyaadhi

paridheeya dhamani vyaadhi (pyaad) anedi gunde ledhaa medaduku sarafara chese dhamanulu kakunda itara dhamanula asaadhaarana sankuchitam. pyaad yea raktanaalamloo ayina sambhavinchavachhu, conny idhi chetula kante kaallaloo ekkuvagaa untundi.
gundelo irukainappudu, dheenini coronary artary disease (cad) anie, medadulo dheenini cerebrovascular disease anie pilustaaru. paridheeya dhamani vyaadhi saadhaaranamgaa kaallanu prabhaavitam chestundi, conny chetulu, meda ledhaa moothrapindaala vanti itara dhamanulu kooda indulo undavacchu.
paridheeya dhamani vyaadhi (pyaad) anedi paridheeya vascular vyaadhi yokka oka roopam. vascular anedi sariiramlooni dhamanulu mariyu siralu rendintinee suuchistumdi. pyaad paridheeya sirala vyaadhi nundi bhinnamgaa untundi. pyaad antey dhamanulu irukainavi ledhaa addaginchabaddaayi-gunde nundi sariiramlooni itara bhagalaku dhooramgaa velletappudu oxygen adhikamgaa unde raktaanni teesukuvelle naalaalu. marovaipu, paridheeya sirala vyaadhi anedi siralatho samasyalanu suuchistumdi-raktaanni tirigi gundeku teesukuvacche naalaalu.
nadaka samayamlo kaalu noppi anedi classic lakshanam, idhi vishraanti thoo parishkarinchabadutundi, dheenini adapadadapa claudication anie pilustaaru. itara lakshanaalalo charmapu puutala, neelam rangu charmam, challani charmam ledhaa prabhaavita kaalilo asaadhaarana goru mariyu juttu perugudala unnaayi. sanklishtatalalo vichhedanam avasaramayye sankramana ledhaa kanajaala maranam undavacchu; coronary artary vyaadhi ledhaa stroke. pyaad unnavaarilo 50 saatam varaku etuvanti lakshanaalu undavu.
pyaadku atipedda pramaada karakam sigaret dhumapanam. itara pramaada karakalalo madhumeham, adhika raktapotu, moothrapindaala samasyalu mariyu adhika rakta collustroll unnaayi. pyaad pradhanamgaa dhamanulalo kovvu phalakam peragadam valla sambhavistundi, dheenini atherosclerosis anie pilustaaru, mukhyamgaa 40 ellu paibadina vyaktulalo. itara vidhanalalo dhamani timmiri, raktam gaddakattadam, gaayam, fibromuscular dysplasia mariyu vasculitis unnaayi. cheelamanda-brockial index (abii) 0.90 kante takkuvagaa unnatlu kanugonadam dwara pyaad saadhaaranamgaa nirdhaarana cheyabadutundi, idhi cheelamanda vadda systolic raktapotunu cheyi yokka systolic rakthapotutho vibhajinchadam. duplexes ultrasonography mariyu angiographyni kooda upayoginchavacchu. angiography marinta khachitamainadi mariyu adhe samayamlo chikitsaku anumatistundi; ayithe, idhi ekkuva pramaadaalatoo mudipadi untundi.
lakshanaalu laeni vyaktulalo paridheeya dhamani vyaadhi kosam screening upayogakaramgaa undaa anedi spashtamgaa teliyadu, endukante idhi sarigga adhyayanam cheyabadaledu. pyaad nundi adapadadapa claudication unnavaarilo, dhumapanam apadam mariyu paryaveekshinchabadina vyayama chikitsa phalitaalanu meruguparachavacchu. stattins, aes inhibitors mariyu silostazole vanti mandulu kooda sahaayapadavachhu. raktaanni sannabadataaniki mariyu tadwara raktapotunu meruguparachadaaniki sahayapade aspirin, telikapati vyaadhi unnavaariki sahaayapadadu, conny gundepotula pramaadam ekkuvagaa unnanduna marinta mukhyamaina vyaadhi unnavaariki saadhaaranamgaa sifaarsu cheyabadutundi. warfarin vanti anticogulants (blood thiners) padlo prayojanam gurinchi khachitamaina shaastreeya aadhaaraalanu choopinchavu. pyaad chikitsaku upayoginche shastrachikitsa vidhanalalo baipas grafting, angioplasty mariyu etherectomy unnaayi.
prabhaavitamavutaaru prapanchavyaaptamgaa sumaru 15.5 kotla mandhi prajalu pyaad kaligi unnaaru. idhi vayassutho marinta saadhaaranam avutundi. abhivruddhi chendina deshaalalo, idhi 45 nundi 50 samvatsaraala vayassu gala vaarilo 5.3% mariyu 85 nundi 90 samvatsaraala vayassu gala vaarilo 18.6% nuu prabhaavitam chestundi. abhivruddhi chendutunna deshaalalo, idhi 45 nundi 50 samvatsaraala madhya vayassu gala 4.6% prajalanu mariyu 85 nundi 90 samvatsaraala madhya vayassu gala 15% prajalanu prabhaavitam chestundi. abhivruddhi chendina deshaalalo pyaad purushulu mariyu mahilalalo samanamga saadhaaranam, ayithe abhivruddhi chendutunna deshaalalo, mahilalu ekkuvagaa prabhaavitamavutaaru. prabhaavitamavutaaru pyaad phalitamgaa sumaru 52,500 maranaalu sambhavinchaayi, idhi idhi 16,000 maranaala nundi perugudala.
sankethaalu mariyu lakshanaalu.
paridheeya dhamani vyaadhi sankethaalu mariyu lakshanaalu prabhaavitamaina shareera bhagampai aadharapadi untaayi. pyaad baarina padina rogulalo daadaapu 66 saatam mandiki lakshanaalu undavu ledhaa asaadhaarana lakshanaalu untaayi. atyanta saadhaaranamaina lakshanam adapadadapa claudication (ii. sii), idhi saadhaaranamgaa vyayamam samayamlo sambhavinche diguva anchu asthipanjara kandaraala noppini suuchistumdi. asthipanjara kandaraala jeevakriya avasaralanu teerchadaaniki taginanta oxygen pampinhee lenappudu aisi andistundi. aisi anedi paridheeya dhamani vyaadhi (pyaad) yokka saadhaarana abhivyakti. noppi saadhaaranamgaa prabhaavita kaalulooni dhooda kandaraalalo untundi mariyu vishraanti dwara upasamanam pondutundi. vyayamam chesetappudu kandaraalaku ekkuva oxygen avasaram kabatti idhi jarugutundi. saadhaaranamgaa, dhamanulu rakta pravahanni penchagalavu, anduvalla vyayamam chesina kandaraalaku vellae oxygen mottaanni penchutaayi. ayithe, padlo, kandaraala yokka oxygen kosam perigina demandku dhamani tagina vidhamgaa spandinchadu mariyu phalitamgaa kandaraalaku oxygen kolpovadam valla kandaraala noppi visraantini taggistundi.
itara lakshanaalu undavachuhu
teevramaina pyaad unna vyaktulalo, klishtamaina limb ischemia mariyu gangreen thoo sahaa samasyalu talettavachhu. raktanaalamloo rakta pravaahaaniki addanki raktam vishraanti samayamlo kanajaalam yokka oxygenationnu nirvahinchaleni sthaayiki raajee padinapudu klishtamaina limb ischemia sambhavistundi. idhi vishraanti samayamlo noppi, jalubu ledhaa prabhaavita paadaalu mariyu kaali vellalo timmiriki daariteeyavachchu. teevramaina pyaad yokka itara samasyalalo diguva avayava kanajaala nashtam (vichhedanam), dhamani lopam puutala, angastambhana mariyu gangreen unnaayi. madhumeham unna vyaktulu prabhaavitam kaani janabha kante 30 retlu ekkuva retutho paadaala gangreen dwara prabhaavitamavutaaru. vichchaedaanaaniki daariteesevi vanti eee teevramaina samasyalalo chaalaa varaku tirigi pondalenivi.
kaaranaalu.
pramaada karakalu.
pyaad pramaadaanni penchadaaniki dohadapade karakalu atherosclerosis kuu samanamga untaayi. veetilo vayassu, lingam mariyu jaathi unnaayi. pyaad anedi streela kante purushulalo rendu retlu ekkuva. jaathi paramgaa, 2:1 nishpattilo tellajati janaabhaato poliste rangu prajalalo pyaad ekkuvagaa untundi. hyperlipidemia, adhika raktapotu, diabetes mellitus, deerghakaalika moothrapindaala vyaadhi mariyu dhumapanam anevi atyanta pramaadakara anubandham kaligina karakalu. veetilo moodu ledhaa anthakante ekkuva karakalu pradarsinchadam valla pyaad abhivruddhi chendhe pramaadam padhi retlu perugutundi.
adhika pramaada janabha.
paridheeya dhamanula vyaadhi eee janabhalo sarvasaadhaaranamh
etiology mariyu pathophysiology.
paridheeya dhamani vyaadhi deerghakaalika ledhaa teevramaina syndromela samitigaa pariganinchabadutundi, idhi saadhaaranamgaa moosukupoye dhamani vyaadhi undatam valla vastundi, idhi avayavalaku taginanta rakta pravahanni kaligistundi.
gatamlo cheppinatlugaa, paridheeya dhamani vyaadhi yokka atyanta saadhaarana kaaranaala, mukhyamgaa 40 ellu paibadina rogulalo, atherosclerosis. etherosclerosis anedi lipid ledhaa kovvu peragadam mariyu prabhaavita dhamanula godalo calcium nikshepana valla dhamanulu irukainatlu kavadam.
atherosclerosis yokka pathophysiologylo collustroll mariyu vascular kanaala madhya sanklishta paraspara charyalu untaayi. pyaad yokka prarambha dasalalo, dhamanulu naalaala gundaa pravahanni kaapaadataaniki vistarinchadam dwara phalakam nirmaanaanni bharti chestaayi. chivariki, dhamani marinta vistarinchadu, mariyu atherosclerotic phalakam dhamani pravaham lumennu irukaina praarambhamavutundi.
paridheeya kanajaalaala avasaralu mariyu rakta sarafara madhya asamatulyata unnappudu, manam ischemia paristhitini edurkontamu.
pathophysiologic konam nundi, diguva avayavaala rakta sarafara (ischemia) parimitini kriyaatmaka ledhaa klishtamainadigaa vargeekarinchavachhu. vishraanti samayamlo rakta pravaham saadhaaranamainappatikii vyayamam samayamlo sariponippudu functional ischemia sambhavistundi, idhi vaidyaparamgaa adapadadapa claudicationga pradarsinchabadutundi. rakta pravaham taggadam valla vishraanti samayamlo perfusion lotu erpadutundi mariyu vishraanti samayamlo noppi ledhaa kaallaloo trophic gayalu undatam dwara critical ischemia utpatti avutundi. eee paristhitiloo, khachitamaina roganirdhaarana praadhamikamainadi, endukante shastrachikitsa dwara ledhaa endovascular therapy dwara taginanta rakta pravahanni tirigi sthaapinchakapothe avayavam kolpoye spashtamaina pramaadam undhi. pyaad unna rogulalo chikitsa suuchana mariyu rooga niroopananu sthaapinchadaaniki rendu bhavanala madhya thedaanu gurtinchadam mukhyam.
itara kaaranaalalo vasculitis mariyu hypercoagulable sthithulaku sambandhinchina "inn situ" thrombosis unnaayi. dhamani timmiri mariyu fibromuscular dysplasiatho sahaa paridheeya dhamani vyaadhi yokka adanapu vidhanalu. dhamanula timmiri yokka kaaranam mariyu pathophysiology puurtigaa ardham kaaledu, conny gaayam rendava sthaanamlo sambhavinchavacchani oohinchabadindi. dhamani noppulu ledhaa tananu taanu biginchi, addankini srushtinchinappudu claudication lakshanaalu erpadataayi. atherosclerosis maadirigaane, idhi addanki diguva kanajaalaaniki rakta pravaham taggadaaniki daariteestundi. raktam gaddakattadam ledhaa raktam gaddakattadam anedi saadhaaranamgaa stabdata ledhaa gaayam kaaranamgaa sambhavistundi.
rooga nirdhaarana.
paridheeya dhamani vyaadhini nirdhaarinchadaaniki ledhaa gurtinchadaaniki lakshanaala charitra mariyu dhruvikarana pareeksha taruvaata saareeraka pareeksha avasaram. eee pareekshalalo siti skaanlu (computed tomraphic angiography), mra skaanlu (magnetic resonance angiography) ledhaa imaging kosam ultrasoundlu undavacchu. paridheeya dhamani vyaadhiki anugunamgaa unde lakshanaala amarikalo oka vaidyudu nirdishta pareeksha phalitaala kosam oka vyaktini pariseelistaaru. asaadhaarana saareeraka pareeksha phalitaalu aarogya samrakshana pradaata oka nirdishta rooga nirdhaarananu pariganaloki teesukoovadaaniki daariteestaayi. ayithe, rooga nirdhaarananu nirdhaarinchadaaniki, nirdhaarana pareeksha avasaram.
eee phalitaalu paridheeya dhamani vyaadhitho mudipadi unnaih
paridheeya dhamani vyaadhi anumaaninchinatlayithe, praathamika adhyayanam cheelamanda-brockial suuchika (abii). abii anedi oka saadhaarana, invasive kaani pareeksha, idhi cheelamandaloni systolic raktapotu mariyu eguva cheyi looni systolic raktapotu nishpattini kolustundi. cheelamandalo raktapotu reedingulu chetiki unna vaati kante takkuvagaa unte, gunde nundi cheelamandaku raktaanni andinche dhamanulalo addanki unnatlu anumaaninchabadutundane aalochanapai idhi aadharapadi untundi. 0. 0 nundi 1.40 varaku unna abii paridhini saadhaaranamainadigaa pariganistaaru. abii 0.90 kante takkuvagaa unnappudu oka vyaktiki pyaad unnatlu pariganinchabadutundi. ayithe, abii 0.01 mariyu 0.90 madhya unte pyaadnu telikapati nundi mitamainadigaa mariyu abii 0.40 kante takkuvagaa unte teevramgaa vargeekarinchavachhu. eee vargaalu vyaadhi course gurinchi antardrushtini andinchagalavu. inca, 0.91 nundi 0.99 varaku unna abii viluvalu sarihaddu rekhagaa pariganinchabadataayi mariyu 1.40 kante ekkuva viluvalu anachiveyaleni dhamanulanu suuchistaayi. abii> abii> lekkinchinatlayithe, idhi calcification valla erpade naalaala goda drudatvaanni suuchistumdi, idhi aniyantrita madhumeham unnavaarilo sambhavinchavachhu. asadhaaranamgaa adhika abis (> 1.40) saadhaaranamgaa tappudu pratikuulamgaa pariganinchabadataayi, anduvalla, ituvanti phalitaalu tadupari parisoedhana mariyu unnata sthaayi adhyayanalaku arhamainavi. sampeedana rahita dhamanulu unna vyaktulu rendu samvatsaraala vyavadhilo hridaya sambandha maranaala pramaadaanni penchutaaru.
anumaanaaspada pyaad unna vyaktulalo saadhaarana abis thoo abii yokka vyayama pareeksha cheyinchukovacchu. vyayamam cheyadaaniki mundu oka baseline abii pondabadutundi. claudication noppi (garishtamgaa 5 nimishalu) vachhe varaku roogi vyayamam cheyamani korataru (saadhaaranamgaa rogulanu treadmillupy sthiramaina vegamtho nadavamani pilustaaru), aaa taruvaata cheelamanda ottidini mallee kolustaaru. 15%-20% yokka abilo taggudala anedi pyaad yokka roganirdhaarana avutundi.
abis asadhaaranamgaa unte, tadupari dasha saadhaaranamgaa atherosclerosis yokka addanki mariyu paridhini chuudataaniki diguva avayavam doppler ultrasound. itara imagingnu angiography dwara nirvahinchavacchu, ikkada kaathetarnu saadhaarana toda dhamani loki choppinchi, prashnaarthakamaina dhamani enchukoni maarganirdesam chestaaru. radeo-dattamaina contrast agentnu inject chesetappudu, ex-rae teesukobadutundi. ex-raeloe kanipinche edainaa rakta pravahanni parimitam chese addankini etherectomy, angioplasty ledhaa stentingtho sahaa vidhaanaala dwara gurtinchavacchu mariyu chikitsa cheyavachu. contrast angiography anedi atyanta sulabhamgaa labhinche mariyu vistrutamgaa upayoginche imaging technic. aadhunika kampyootareekarinchina tomography (siti) scannerlu dhamani vyavastha yokka pratyaksha imagingnu andistaayi. 50 saatam kante ekkuva stenosis unna gayalanu gurtinchadamlo siti yokka sunnitatvam mariyu vishishtatanu adhyayanalu varusaga 95 saatam mariyu 96 saatamgaa choopinchaayi. anduvalla, sitini invasive angiographyki pratyamnaayamgaa pariganinchavacchu. rendinti madhya oka mukhyamaina vyatyaasam emitante, invasive angiography vale kakunda, siti thoo dhamani vyavastha yokka anchanaa vascular jokyaniki anumatinchadu.
magnetic resonance angiography (mra) anedi oka naan-invasive diagnostic prakriya, idhi sareeram lopala rakta naalaala vivaranaatmaka chitraalanu roopondinchadaaniki pedda ayaskaantam, radeo pounahpunyaalu mariyu computer kalayikanu upayogistundi. mra yokka prayojanaalu daani bhadrata mariyu adhika resolution, mottam pottikadupu, pottikadupu mariyu diguva antya bhagala trimiteeya imagingnu okesari andinche saamarthyam.
vargeekarana.
paridheeya dhamani vyaadhini vargeekarinchadaaniki saadhaaranamgaa upayoginche rendu paddhatulu fantine mariyu rutherford vargeekarana vyavasthalu. deerghakaalika limb ischemia yokka teevratanu nirvachinchadaaniki nirvachinchadaaniki rene fantine fantine dwara fantine dasalanu pravesapettaaruh
pravesapettaaruh pravesapettina mariyu mariyu savarinchina (mariyu pradhana rachayita robbert bii. taruvaata rutherford vargeekaranagaa piluvabade) society pharr vascular surgery mariyu international society off cardiovascular surgery dwara rutherford vargeekarana srushtinchabadindi. rutherford). eee vargeekarana vyavasthalo naalugu taragatulu mariyu edu vargaalu (vargaalu 0-6) untayih
fantine yokka dasalu III nundi IV ledhaa rutherford yokka vargaalu 4 nundi 5 dwara vargeekarinchabadina mitamaina nundi teevramaina pyaad, klishtamaina limb ischemia roopamlo limb muppu (limb nashtam pramaadam) nuu andistundi.
iteevala, society pharr vascular surgery "gaayam, ischemia mariyu phut infection" (vaifai) aadhaaramgaa vargeekarana vyavasthanu roopondinchindi. maargadarsakam prachurinchabadina eee vargeekarana vyavastha, gatha nalabhai samvatsaraalugaa adhika raktamlo chakkera sambhavam peragadam mariyu abhivruddhi chendutunna paddhatulu mariyu punaruddharana saamardhyamtho sahaa sambhavinchina janabha maarpulanu parigananaloki teesukoovadaaniki roopondinchabadindi. eee vyavastha ischemia mariyu angiographic vyaadhi namuunaala aadhaaramgaa srushtinchabadindi, ivi vichhedanam pramaadaanni nirnayinche ekaika karakalu kaavu. vaifai vargeekarana vyavastha rendu bhagaluga vibhajinchabadindih gayalu mariyu ischemia. vranotpatti mariyu/ledhaa gangreen mariyu ischemia unnanduna gayalanu 0 nundi 3 varaku vargeekaristaaru.
ischemia abii, cheelamanda systolic ottidi mariyu kaali ottidi aadhaaramgaa 0 nundi 3 varaku vargeekarinchabadutundi.
task (mariyu task II) vargeekarana suuchimchina pyaad chikitsa angiogram meeda kanipinche vyaadhi teevratapai aadharapadi untundi.
screening.
vistrutamgaa adhyayanam cheyabadananduna saadhaarana janabhalo vyaadhi kosam screening upayogakaramgaa untundaa anedi spashtamgaa teliyadu. indulo cheelamanda-brockial index (abii) thoo screening untundi, ayithe saahityam yokka kramabaddhamaina sameeksha lakshanarahita rogulalo saadhaarana abii screening vaadakaaniki maddatu ivvaledu.
coronary artary vyaadhi ledhaa caroted artary vyaadhi kosam pareekshinchadam valla aspashtamaina prayojanam undhi. pottikadupu bruhaddhamani raktanaalaala (aaa) kuu pyaad pramaada karakam ayithe, pottikadupu bruhaddhamani raktanaalaala kosam lakshanarahita pyaad unna vyaktulanu pareekshinchadampai dayta ledhu. rogalakshana pyaad screening unna vyaktulalo aaa kosam ultrasound dwara asamanjasamainadi kaadu.
chikitsa.
vyaadhi teevratanu batti, eee maargadarsakaala prakaram eee charyalu teesukovachhuhu
mandulu.
maargadarsakaala prakaram, rogalakshana paridheeya dhamani vyaadhi unnavaarilo ami ("gundepotu"), stroke mariyu vascular maranaaniki itara kaaranaalanu tagginchadaaniki aspirin ledhaa clopidogrel teesukovadam sifaarsu cheyabadindi. aspirin mariyu clopidogrelnu okadaanitoe okati kalipi kakunda ontarigaa teesukoovaalani sifaarsu cheyabadindi (i.ii., dwandwa antipletlet therapyga kaadu). pyaad chikitsa kosam sifaarsu cheyabadina rojuvaaree motaadu aspirin 75 mariyu 325 mg madhya untundi, clopidogrel kosam sifaarsu cheyabadina rojuvaaree motaadu 75 mg. rogalakshana pyaad unnavaarilo hridayanaala ischemic sanghatanala pramaadaanni tagginchadaaniki aspirin mariyu clopidogrel rendinti prabhavam baga sthaapinchabadaledu. takkuva motaadu gala rivaroxaban plus aspirin pyaad kosam kotta anty thrombotic niyamamgaa prabhaavavantamgaa untundani parisoedhanalu suuchistunnaayi.
silostazole konnintiloo lakshanaalanu meruguparustundi. pentoxifilline aspashtamaina prayojanam kaligi untundi. paridheeya dhamani vyaadhi kaaranamgaa claudicationnu anubhavinche vyaktulaku silostazole nadaka dooraanni meruguparachavacchu, conny idhi jeevana naanhyatanu meruguparustundani, maranaalanu taggistundani ledhaa hridaya sambandha sanghatanala pramaadaanni taggistundani balamaina aadharalu suuchimchavu.
itara mandulu ledhaa vitaminlatho chikitsaku clinical aadhaaraala dwara maddatu ledhu, "ayithe hyperhomocystenemiapi folate mariyu vitamin vitamin prabhavanni anchanaa vese trials, oka sambhaavya vascular pramaada karakam, daadaapu puurtavutunnaayi".
punaruddharana.
paina perkonna uttama vaidya chikitsa yokka pareeksha tarvaata, lakshanaalu konasagithe, rogulanu vascular ledhaa endovascular sarjanku suuchimchavachchu. punaruddharana yokka prayojanam ischemia yokka teevrata mariyu gaayam mariyu sankramana teevrata vanti avayava nashtam kosam itara pramaada kaarakaala unikiki anugunamgaa untundani bhaavistunnaaru.
maargadarsakaalu.
2005 mariyu 2011 maargadarsakaalanu kalipi, diguva anchu, moothrapinda, macenteric mariyu pottikadupu mahadhamani pyaad yokka rooga nirdhaarana mariyu chikitsa kosam american college off cardiology mariyu american haart association nundi maargadarsakam maargadarsakam sankalanam cheyabadindi. deerghakaalika avayava bedirimpu ischemia kosam, 2 samvatsaraalu ledhaa anthakante takkuva ayurdayam unnavaariki ledhaa autogenous sira andubaatulo laeni vaariki matrame beloon angioplastini acoff/aahaa maargadarsakaalu sifaarsu chestaayi. 2 samvatsaraala kante ekkuva ayurdayam unnavaariki, ledhaa autogenous sira unnavaariki, baipas shastrachikitsa sifaarsu cheyabadindi.
rooga niruupana.
pyaad unna vyaktulu "hridaya sambandha sanghatanalaku anoohyamgaa perigina pramaadaanni kaligi untaaru mariyu majority chivariki cardiac ledhaa cerebrovascular etiologytho maranistaaru"; rooga niruupana anedi abii dwara kolichina pyaad teevratatoo sambandham kaligi untundi. pedda-nauka pyaad hridaya sambandha vyaadhula nundi maranaalanu gananeeyamgaa penchutundi. pyaad "10 samvatsaraalalo coronary eevent yokka 20 saatam kante ekkuva pramaadaanni" kaligi untundi.
claudication unna vyaktiki teevramaina ischemia vachhe pramaadam takkuvagaa untundi mariyu vichhedanam avasaram, conny coronary sanghatanala nundi maraninche pramaadam claudication lekunda saripolina niyantranala kante moodu nundi naalugu retlu ekkuva. adapadadapa claudication unna rogulalo, "7 saatam matrame takkuva-teevrata baipas shastrachikitsa, 4 saatam pedda vichhedanam mariyu 16 saatam digajaarutunna claudication" cheyinchukuntaaru, conny stroke mariyu gundepotu sanghatanalu perugutaayi, mariyu "5 samvatsaraala maranaala raetu 30 saatamgaa anchanaa veyabadindi (niyantranalo 10 saataaniki vyatiraekamgaa)".
epidemiology.
saadhaarana janabhalo pyaad praabalyam 3-7%, idhi 70 ellu paibadina vaarilo 20 saatam varaku prabhaavitam chestundi; 70%-80% prabhaavita vyaktulalo lakshanaalu laevu; alpasankhyaakulaku matrame eppuduu punaruddharana ledhaa vichhedanam avasaram. paridheeya dhamani vyaadhi 50 ellu paibadina mugguru madhumeham rogulalo okarini prabhaavitam chestundi. samyukta rashtraalalo, idhi 65 samvatsaraalu mariyu anthakante ekkuva vayassu unna americanlalo 12-20 saataanni prabhaavitam chestundi. sumaru 10 millionla mandhi americanlaku pyaad undhi. daani praabalyam mariyu hridaya sambandha pramaada chikkulu unnappatikee, pramaada karakalu mariyu lakshanaala gurinchi avagahana inca takkuva sthaayilo undhi, us janabhalo 26 saatam mandiki pyaad gurinchi ghnaanam undani nivedistunnaru.
nivedistunnaru united stateslo 40 samvatsaraalu mariyu anthakante ekkuva vayassu unnavaarilo, pyaad raetlu 4.3% unnaayi. raetlu 70 samvatsaraalu ledhaa anthakante ekkuva vayassu unna vyaktulu 14.5%. vayassu samoohaalalo, purushula kante mahilallo raetlu saadhaaranamgaa ekkuvagaa undevi. hysponic kaani nallajaateeyulu 7.9% raetlu kaligi undagaa, hysponic kaani swetajaateeyulalo 4.4% mariyu mexican americanlalo 3.0% (1.4%-4.6%) unnaayi.
rogalakshana pyaad sambhavam vayassutho paatu perugutundi, 40-55 samvatsaraala vayassu gala purushulaku samvatsaraaniki sumaru 0.3 saatam nundi 75 ellu paibadina purushulaku samvatsaraaniki sumaru 1 saataaniki perugutundi. pyaad yokka praabalyam pyaad elaa nirvachinchabadutundane daanipai mariyu adhyayanam cheyabadutunna janabha vayassunu batti gananeeyamgaa maarutundi. pyaad unnatlu nirdhaarana ayina vyaktulaku gada (pradhana pratikuula hridaya sanghatana) mariyu stroke vachhe pramaadam ekkuvagaa untundi. gundepotu tarvaata oka samvatsaramlone reinfraction/stroke/taatkaalika ischemic attack vachhe pramaadam pyaad laeni vaariki 11.4% thoo poliste 22.9% kii perugutundi.
diabetes niyantrana mariyu sanklishtatala vichaarana mariyu type 1 mariyu type 2 diabetes unnavaarilo UK sambhaavya diabetes adhyayana trials, varusaga, microvascular vyaadhi kante microvascular vyaadhitho glycemic niyantrana marinta balamgaa mudipadi undani niroopinchaayi. pedda dhamanulalo sambhavinche atherosclerosis kante chinna naalaalaloo sambhavinche rogalakshana maarpulu deerghakaalikamgaa perigina glucose sthaayilaku marinta sunnitamgaa undavacchu.
parisoedhana.
pyaad purogatini nivaarinchadaaniki chikitsalapai parisoedhanalu jarugutunnaayi. kaallaku rakta pravaham teevramgaa takkuvagaa unnavaarilo, autologus mononuclear kanaala autotransplantation yokka prayojanam aspashtamgaa undhi.
teevramaina pyaad chikitsa kosam vascular baipasnu angioplastytho polchadam kosam oke oka yaadruchchika niyantrita trial nirvahinchabadindi. pranaalikaabaddhamaina clinical end point vadda vascular baipas mariyu angioplasty madhya vichhedanam laeni manugadalo etuvanti vyatyaasam ledani trial kanugondi, ayithe trial takkuva saktitoe, endovascular empikalanu parimitam chestu, anuchitamaina end paayintlanu polchadam vanti vimarsalaku guraindi. 2017 natiki, teevramaina pyaad mariyu klishtamaina limb ischemia (klai), uttama-klai (klishtamaina limb ischemia unna rogulaku uttama endovascular verses uttama shastrachikitsa chikitsa) trial, mariyu tulasi-2 (legg yokka teevramaina ischemialo baipas verses angioplasty-2) trial kosam saraina punaruddharana saanketikatanu baga ardham chesukovadaniki rendu yaadruchchika clinical trials nirvahinchabadutunnaayi.
nirvahinchabadutunnaayi, 2011loe russialo klishtamaina limb ischemia yokka adhunaatana dasato sahaa pyaad chikitsa kosam modati-taragati janyu chikitsa aushadhamgaa namodu cheyabadindi.

