Risk factors for peripheral arterial disease in the tropics and its comparison with the western population

Objective:To identify and compare the existence of similar and other risk factors in the perspective of an Indian population.Methods:It was designed as a case control study and was conducted in the Department of General and Vascular Surgery Unit 2 of Christian Medical College,Vellore,India between the periods July 2003 to June 2005.100 patients with an ABPI【 0.9 and 100 controls were studied.Results:Peripheral arterial disease(PAD) was found to be commoner among males(87%).While atherosclerosis was the commonest aetiology(54%),the incidence of Thromboangiitis Obliterans was also not uncommon(38%).Smoking was the main risk factor in the Indian context(83%) as compared to hypercholesterolemia(60%) in the West. The patients with atherosclerotic PAD were middle-aged and had concomitant diabetes(50%) and hypertension(30%).Conclusions:Peripheral arterial disease occurs in a relatively younger age group in India as compared to their Western counterparts.Thromboangiitis Obliterans was found to be a significant aetiology for arterial occlusive disease,with smoking as the primary risk factor followed by diabetes,hypertension and hypercholesterolemia.

Controlled study of conventional surgery and ultrasound guided foam sclerotherapy for the treatment of primary SVI of lower limbs

Objective:To compare conventional surgery and ultrasound guided foam sclerotherapy for primary superficial venous insufficiency(SVI)with respect to obliteration of superficial venous system,clinical outcome and cost.Methods:The study was conducted between September 2005 and March 2006,in Surgery department of Christian Medical College Hospital,Vellore.All patients with symptomatic primary venous insufficiency of lower limbs requiring definitive management were randomized to conventional surgery(n=30)or ultrasound guided foam sclerotherapy(n=30).Obliteration of superficial venous system at 3 months,clinical outcome and costs were registered.Results:Superficial venous system was obliterated in all the patients of both the groups at 3 months.Improvement in clinical scores and complication rates was similar in both the groups.The foam sclerotherapy group had less analgesic requirement,earlier return to work and lower cost.Conclusion:Foam sclerotherapy is a cheaper alternative to surgery for primary venous insufficiency with respect to early measures of clinical outcome.