Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia

T. Raymond Foley, Stephen W. Waldo, Ehrin J. Armstrong

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number42
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume18
Issue number7
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Keywords

  • Critical limb ischemia
  • Peripheral artery disease
  • Therapy
  • Vascular disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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