title: Changes in flow-mediated dilatation in patients with femoropopliteal occlusion receiving conservative and invasive treatment.
abstract: BACKGROUND
  Although the beneficial effect of revascularisation on reduction of local clinical ischaemic symptoms has been well established, its effect on systemic vascular endothelial function has not been fully explained yet.
  
  
  OBJECTIVE
  To determine changes in endothelium-dependent flow-mediated dilatation in patients with unilateral femoropopliteal occlusion receiving medical and surgical treatment.
  
  
  METHODS
  Seventy-nine patients with symptomatic atherosclerotic ischaemia of lower extremities, treated with endovascular procedures, with femoropopliteal graft, or receiving conservative treatment (21-day controlled treadmill training) were enrolled in the study. Ankle brachial pressure index (ABPI), skin blood flow on the feet, and flow-mediated dilatation (FMD) of brachial arteries were measured in each patient at baseline and after 90 days of follow-up.
  
  
  RESULTS
  The ABPI, vasomotion in the myogenic frequency band, and FMD increased significantly in surgical patients. In patients after femoropopliteal bypass a significant increase of vasomotion in the endothelial frequency band was also observed. In patients receiving conservative treatment (treadmill training), vasomotion in the myogenic frequency band increased whereas the FMD remained unchanged.
  
  
  CONCLUSIONS
  It seems that surgical treatment may contribute to reducing the risk of cardiovascular complications in patients with advanced peripheral artery disease, as a result of improving the systemic vascular endothelial function. Limiting treatment to just treadmill training increases pain-free walking distance but does not improve systemic vascular endothelial function.
authors.affiliation: Department of Hypertensiology, Angiology, and Internal Diseases, Medical University, Poznan, Poland. kati2911@poczta.onet.eu.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Pawlaczyk
authors.forename: Marcin
authors.initials: M
authors.lastname: Gabriel
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urbanek
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Dzieciuchowicz
authors.forename: Beata
authors.initials: B
authors.lastname: Begier-Krasińska
authors.forename: Michał
authors.initials: M
authors.lastname: Stanisić
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Wachal
authors.forename: Maciej
authors.initials: M
authors.lastname: Zieliński
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*; D005081:Exercise Therapy; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D016896:Treatment Outcome
keywords: endothelial dysfunction; endothelial flow-mediated dilatation; flowmotion; peripheral arterial occlusive disease; treadmill training