Display Settings:

Format

Send to:

Choose Destination
Mayo Clin Proc. 2010 Jul;85(7):678-92. doi: 10.4065/mcp.2010.0133.

Peripheral artery disease: current insight into the disease and its diagnosis and management.

Author information

  • 1Zena and Michael A Wiener Cardiovascular Institute, Marie-Josée and Henry R Kravis Center, Cardiovascular Health, Mount Sinai Medical Center, New York, NY 10029, USA. jeffrey.olin@mountsinai.org

Abstract

Peripheral artery disease (PAD), which comprises atherosclerosis of the abdominal aorta, iliac, and lower-extremity arteries, is underdiagnosed, undertreated, and poorly understood by the medical community. Patients with PAD may experience a multitude of problems, such as claudication, ischemic rest pain, ischemic ulcerations, repeated hospitalizations, revascularizations, and limb loss. This may lead to a poor quality of life and a high rate of depression. From the standpoint of the limb, the prognosis of patients with PAD is favorable in that the claudication remains stable in 70% to 80% of patients over a 10-year period. However, the rate of myocardial infarction, stroke, and cardiovascular death in patients with both symptomatic and asymptomatic PAD is markedly increased. The ankle brachial index is an excellent screening test for the presence of PAD. Imaging studies (duplex ultrasonography, computed tomographic angiography, magnetic resonance angiography, catheter-based angiography) may provide additional anatomic information if revascularization is planned. The goals of therapy are to improve symptoms and thus quality of life and to decrease the cardiovascular event rate (myocardial infarction, stroke, cardiovascular death). The former is accomplished by establishing a supervised exercise program and administering cilostazol or performing a revascularization procedure if medical therapy is ineffective. A comprehensive program of cardiovascular risk modification (discontinuation of tobacco use and control of lipids, blood pressure, and diabetes) will help to prevent the latter.

Comment in

PMID:
20592174
[PubMed - indexed for MEDLINE]
PMCID:
PMC2894725
Free PMC Article

Images from this publication.See all images (2)Free text

FIGURE 1.
FIGURE 2.
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Write to the Help Desk