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 Citations (Scopus)

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

Fingerprint

Peripheral Arterial Disease
Ischemia
Extremities
Therapeutics
Nociceptive Pain
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Exercise Therapy
Intermittent Claudication
Limb Salvage
Platelet Aggregation Inhibitors
Smoking Cessation
Walking
Aorta
Life Style
Lower Extremity
Atherosclerosis
Consensus
Quality of Life
Guidelines
Exercise

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia. / Foley, T. Raymond; Waldo, Stephen W.; Armstrong, Ehrin J.

In: Current Treatment Options in Cardiovascular Medicine, Vol. 18, No. 7, 42, 01.07.2016.

Research output: Contribution to journalReview article

Foley, T. Raymond ; Waldo, Stephen W. ; Armstrong, Ehrin J. / Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia. In: Current Treatment Options in Cardiovascular Medicine. 2016 ; Vol. 18, No. 7.
@article{59060bbcfb3d42389245de5997ede4be,
title = "Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia",
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.",
keywords = "Critical limb ischemia, Peripheral artery disease, Therapy, Vascular disease",
author = "Foley, {T. Raymond} and Waldo, {Stephen W.} and Armstrong, {Ehrin J.}",
year = "2016",
month = "7",
day = "1",
doi = "10.1007/s11936-016-0464-8",
language = "English (US)",
volume = "18",
journal = "Current Treatment Options in Cardiovascular Medicine",
issn = "1092-8464",
publisher = "Current Science, Inc.",
number = "7",

}

TY - JOUR

T1 - Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia

AU - Foley, T. Raymond

AU - Waldo, Stephen W.

AU - Armstrong, Ehrin J.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - 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.

AB - 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.

KW - Critical limb ischemia

KW - Peripheral artery disease

KW - Therapy

KW - Vascular disease

UR - http://www.scopus.com/inward/record.url?scp=84969921472&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84969921472&partnerID=8YFLogxK

U2 - 10.1007/s11936-016-0464-8

DO - 10.1007/s11936-016-0464-8

M3 - Review article

AN - SCOPUS:84969921472

VL - 18

JO - Current Treatment Options in Cardiovascular Medicine

JF - Current Treatment Options in Cardiovascular Medicine

SN - 1092-8464

IS - 7

M1 - 42

ER -