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Internist (Berl). 2011 May;52(5):549-60; quiz 561. doi: 10.1007/s00108-011-2814-7.

[Peripheral arterial disease].

[Article in German]

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II. Medizinische Klinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg Universität Mainz, Langenbeckstrasse 1, Mainz, Germany.


Prevalence of peripheral arterial disease (PAD) is high and patients with PAD have a high rate of cardiovascular mortality. Most patients are clinically asymptomatic, therefore it is important to screen persons using ankle-brachial index. It is useful to combine functional and morphological measurements to diagnose leg perfusion and for planning various treatment options. Treatment of cardiovascular risk factors is central to improve prognosis. Moreover, thrombocyte aggregation inhibitors are indicated. Patients with intermittent claudication should perform an exercise training program. In addition drugs can be used to improve walking distance. In patients with intermittent claudication peripheral intervention can be useful. However, in stable patients surgical treatment should be restricted to single cases. In patients with critical limb ischemia (pain at rest or ulcer/gangrene) percutaneous intervention or bypass surgery must be performed immediately. After successful improvement of leg perfusion the high risk PAD patients should be followed by a regular program for all their life.

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