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J Am Coll Cardiol. 2016 Mar 22;67(11):1338-57. doi: 10.1016/j.jacc.2015.12.049.

Peripheral Artery Disease: Evolving Role of Exercise, Medical Therapy, and Endovascular Options.

Author information

1
Zena and Michael A. Wiener Cardiovascular Institute & Marie-Joseé and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: jeffrey.olin@mountsinai.org.
2
Department of Cardiology, Ochsner Clinical School, New Orleans, Louisiana.
3
Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Denver, Colorado, and Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado.
4
Zena and Michael A. Wiener Cardiovascular Institute & Marie-Joseé and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York.
5
Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, and CPC Clinical Research, Aurora, Colorado.

Abstract

The prevalence of peripheral artery disease (PAD) continues to increase worldwide. It is important to identify patients with PAD because of the increased risk of myocardial infarction, stroke, and cardiovascular death and impaired quality of life because of a profound limitation in exercise performance and the potential to develop critical limb ischemia. Despite effective therapies to lower the cardiovascular risk and prevent progression to critical limb ischemia, patients with PAD continue to be under-recognized and undertreated. The management of PAD patients should include an exercise program, guideline-based medical therapy to lower the cardiovascular risk, and, when revascularization is indicated, an "endovascular first" approach. The indications and strategic choices for endovascular revascularization will vary depending on the clinical severity of the PAD and the anatomic distribution of the disease. In this review, we discuss an evidence-based approach to the management of patients with PAD.

KEYWORDS:

ankle-brachial index; claudication; drug-eluting stents; endovascular therapy; exercise therapy; vascular diseases

PMID:
26988957
DOI:
10.1016/j.jacc.2015.12.049
[Indexed for MEDLINE]
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