Peripheral Arterial Disease

Excerpt

Patients with peripheral arterial disease (PAD) have decreased lower extremity arterial perfusion which is commonly referred to as “poor circulation.” In most cases of PAD, atherosclerotic plaques narrow the arterial flow lumen which restricts blood flow to the distal extremity. Reduced blood flow can cause thigh or calf pain with walking due to temporary ischemia of the leg muscles during exertion. Walking pain from PAD is referred to as intermittent claudication which means “to limp.” Many patients with PAD have either no symptoms or atypical complaints that do not strictly conform to the definition of claudication. Others may develop limb-threatening compromise of blood flow, necessitating emergent surgery.

Making the diagnosis of PAD even in asymptomatic patients still, has a significant clinical impact because PAD acts as a marker for systemic atherosclerosis. Patients with PAD have an equivalent cardiovascular risk to patients with previous myocardial infarction and require aggressive risk factor modification to improve their long-term survival. The management of PAD varies depending on the disease severity and symptom status. Treatment options for PAD include lifestyle changes, cardiovascular risk factor reduction, pharmacotherapy, endovascular intervention, and surgery.