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Current Treatment Options in Cardiovascular Medicine

Published in:

01-07-2016 | Vascular Disease (I Weinberg, Section Editor)

Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia

Authors: T. Raymond Foley, MD, Stephen W. Waldo, MD, Ehrin J. Armstrong, MD, MSc

Published in: Current Treatment Options in Cardiovascular Medicine | Issue 7/2016

Opinion statement

Peripheral artery disease (PAD) comprises atherosclerosis of the aorta and lower extremities. Many patients with PAD are asymptomatic, while others present with intermittent claudication (IC) or critical limb ischemia (CLI). Defined as rest pain or tissue loss that persists for >2 weeks, CLI represents the most severe clinical manifestation of PAD and is associated with an increased risk of limb loss and death. Patients with PAD, including those with CLI, are underdiagnosed and undertreated. In addition to smoking cessation, medical therapy with an antiplatelet agent and statin is recommended for all patients with PAD. Regular exercise has been shown to improve walking distance and quality of life in patients with symptomatic PAD and should be incorporated into each patient’s treatment plan. In patients who have CLI and in those with persistent lifestyle-limiting claudication despite optimal medical therapy and an exercise program, revascularization is indicated for limb salvage and symptom relief, respectively. Consensus guidelines currently support an endovascular first approach to revascularization in the majority of cases. Surgical procedures provide an alternative to endovascular therapy in select cases.

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Title: Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia
Authors: T. Raymond Foley, MD
Stephen W. Waldo, MD
Ehrin J. Armstrong, MD, MSc
Publication date: 01-07-2016
Publisher: Springer US
Published in: Current Treatment Options in Cardiovascular Medicine / Issue 7/2016
Print ISSN: 1092-8464
Electronic ISSN: 1534-3189
DOI: https://doi.org/10.1007/s11936-016-0464-8

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