Publications (27) View all
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Article: The relationship of walking distances estimated by the patient, on the corridor and on a treadmill, and the Walking Impairment Questionnaire in intermittent claudication.
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ABSTRACT: OBJECTIVE: Physicians and patients consider the limited walking distance and perceived disability when they make decisions regarding (invasive) treatment of intermittent claudication (IC). We investigated the relationship between walking distances estimated by the patient, on the corridor and on a treadmill, and the Walking Impairment Questionnaire (WIQ) in patients with IC due to peripheral arterial disease. METHODS: This was a single-center, prospective observational cohort study at a vascular laboratory in a university hospital in the Netherlands. The study consisted of 60 patients (41 male) with a median age of 64 years (range, 44-86 years) with IC and a walking distance ≤250 m on a standardized treadmill test. Main outcome measures were differences and Spearman rank correlations between pain-free walking distance, maximum walking distance (MWD) estimated by the patient, on the corridor and on a standardized treadmill test, and their correlation with the WIQ. RESULTS: The median patients' estimated, corridor, and treadmill MWD were 200, 200, and 123, respectively (P < .05). Although the median patients' estimated and corridor MWD were not significantly different, there was a difference on an individual basis. The correlation between the patients' estimated and corridor MWD was moderate (r = 0.61; 95% confidence interval [CI], 0.42-0.75). The correlation between patients' estimated and treadmill MWD was weak (r = 0.39; 95%, CI 0.15-0.58). Respective correlations for the pain-free walking distance were comparable. The patients' estimated MWD was moderately correlated with WIQ total score (r = 0.63; 95%, CI 0.45-0.76) and strongly correlated with WIQ distance score (r = 0.81; 95% CI, 0.69-0.88). The correlation between the corridor MWD and WIQ distance score was moderate (r = 0.59; 95% CI, 0.40-0.74). CONCLUSIONS: Patients' estimated walking distances and on a treadmill do not reflect walking distances in daily life. Instruments that take into account the perceived walking impairment, such as the WIQ, may help to better guide and evaluate treatment decisions.Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 01/2013; · 3.52 Impact Factor -
Article: Three-Dimensional Rotational Angiography of the Foot in Critical Limb Ischemia: A New Dimension in Revascularization Strategy.
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ABSTRACT: PURPOSE: To evaluate the additional value of three-dimensional rotational angiography (3DRA) of the foot compared with digital subtraction angiography (DSA) in patients with critical limb ischemia (CLI). TECHNIQUE: For 3DRA, the C-arm was placed in the propeller position with the foot in an isocentric position. The patient's unaffected foot was positioned in a footrest outside the field of view. For correct timing of 3DRA, the delay from contrast injection in the popliteal artery at the level of knee joint to complete pedal arterial enhancement was assessed using DSA. With this delay, 3DRA was started after injection of 15 ml contrast. Imaging of the 3DRA could directly be reconstructed and visualized. MATERIALS AND METHODS: Patients undergoing 3DRA of the foot were prospectively registered. DSA and 3DRA images were scored separately for arterial patency and presence of collaterals. Treatment strategies were proposed based on DSA with and without the availability of 3DRA. RESULTS: Eleven patients underwent 3DRA of the foot. One 3DRA was not included because the acquisition was focused on the heel instead of the entire foot. Diagnostic quality of 3DRA was good in all ten patients. 3DRA compared with DSA showed additional patent arteries in six patients, patent plantar arch in three patients, and collaterals between the pedal arteries in five patients. Additional information from 3DRA resulted in a change of treatment strategy in six patients. CONCLUSION: 3DRA of the foot contains valuable additional real-time information to better guide peripheral vascular interventions in patients with CLI and nonhealing tissue lesions.CardioVascular and Interventional Radiology 12/2012; · 2.09 Impact Factor -
Article: Validation of the Dutch version of the VascuQol questionnaire and the Amsterdam linear disability score in patients with intermittent claudication.
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ABSTRACT: To assess the reliability and validity of the Dutch version of the vascular quality of life questionnaire (VascuQol) and the AMC Linear Disability Score (ALDS) in patients with stable intermittent claudication (IC). During a 5-month period we performed a prospective study in which we included every patient with stable IC, who visited our vascular surgery outpatient clinic and consented to participate. Forty consecutive patients filled in the Dutch VascuQol, the ALDS, and Short Form-36 (SF-36). Twenty patients filled in the same questionnaires after 4 weeks. Internal reliability consistencies were expressed as Cronbach's α. Test-retest reliability was expressed as intraclass correlation coefficients (ICC). Construct validity was expressed as Spearman rho correlations between SF-36 and relevant domains of Dutch VascuQol and the ALDS. Internal reliability consistencies were, respectively, good and excellent for the total scores of VascuQol, SF-36, and ALDS (Cronbach's α. 0.87, 0.89, and 0.92). Test-retest reliability was excellent for the total VascuQol scores [ICC 0.91 (95% CI, 0.78-0.96)], and for the ALDS [ICC 0.90 (95% CI, 0.76-0.96)]. Spearman correlations between VascuQol, ALDS, and SF-36 domains varied from r = 0.34-0.79. The Dutch VascuQol is a valid and reliable questionnaire for assessment of Qol in patients with IC. This study confirms the good clinimetric properties of the ALDS for assessing disability in patients with IC.Quality of Life Research 11/2011; 21(8):1487-93. · 2.30 Impact Factor -
Article: Regarding "an analysis of relationship between quality of life indices and clinical improvement following intervention in patients with intermittent claudication due to femoropopliteal disease".
Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 04/2011; 53(4):1164; author reply 1164. · 3.52 Impact Factor -
Article: Pasteurella multocida infection, a rare cause of mycotic abdominal aortic aneurysm.
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ABSTRACT: A 64-year-old man was admitted with abdominal pain 6 weeks after treatment with intravenous flucloxacillin for cellulitis of his right leg. Urgent operation was necessary for a mycotic aneurysm of the abdominal aorta due to infection with Pasteurella multocida, a microorganism residing in the oral cavity of domestic animals that very rarely causes infection of native arteries or grafts. The aorta was repaired with a rifampin-coated tube graft. Despite postoperative duodenal perforation, abdominal Candida infections, wound dehiscence, and renal insufficiency, the patient is alive 1 year postoperatively.Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 09/2009; 50(6):1496-8. · 3.52 Impact Factor
