Abstract
The diagnosis of atherosclerotic peripheral arterial disease (PAD) is often overlooked because the vast majority of patients are either asymptomatic or have atypical symptoms (Anderson JL et al., Circulation 127:1425–1443, 2013; Hirsch AT et al., JAMA 286(11):1317–1324, 2001a). Furthermore, even when atherosclerotic PAD is appropriately diagnosed, these patients are still consistently undertreated (Hirsch AT et al., Vasc Med 6(Suppl 3):9–12, 2001b). In an era when there remains a discordance between the implications of a disease process and the attention that is given to it, familiarity with the diagnostic modalities and treatment strategies cannot be underemphasized. The following chapter will be a comprehensive review of both the diagnosis and medical management of atherosclerotic PAD.
Keywords
- Compute Tomography Angiography
- Magnetic Resonance Angiography
- Peripheral Arterial Disease
- Critical Limb Ischemia
- United Kingdom Prospective Diabetes Study
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References
Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, Fowkes FG, Hiatt WR, Jonsson B, Lacroix P, Marin B, McDermott MM, Norgren L, Pande RL, Preux PM, Stoffers HE, Treat-Jacobson D, American Heart Association Council on Peripheral Vascular Disease, Council on Epidemiology and Prevention, Council on Clinical Cardiology, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular Surgery and Anesthesia (2012) Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation 126(24):2890–2909
Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen W (2013) Management of patients with peripheral artery disease (complication of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 127:1425–1443
Antithrombotic Trialists’ Collaboration (2002) Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71
Beckman JA, Jaff MR, Creager MA (2006) The United States preventive services task force recommendation statement on screening for peripheral arterial disease: more harm than benefit? Circulation 114:861–866
Bhatt DK, Fox KA, Werner Hack CB, Berger PB, Black HR, Boden WE, Cacoub P, Cohen EA, Creager MA, Easton JD, Flather MD, Haffner SM, Hamm CW, Hankey GJ, Johnston SC, Mak K, Mas J, Montalescot G, Pearson TA, Steg PG, Steinhubl SR, Weber MA, Brennan DM, Fabry-Ribaudo L, Booth J, Topol EJ (2006) Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 354:1706–1717
CAPRIE Steering Committee (1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348(9038):1329–1339
Chi Y, Lavie CJ, Milani RV, White CJ (2008) Safety and efficacy of cilostazol in the management of intermittent claudication. Vasc Health Risk Manag 4(6):1197–1203
Creager MC, Beckman JA, Loscalzo J (2013) Vascular medicine. A companion to Braunwald’s heart disease, 2nd edn. Saunders, Philadelphia
Criqui MH, Denenberg JO, Bird CE, Fronek A, Klauber MR, Langer RD (1996) The correlation between symptoms and non-invasive test results in patients referred for peripheral arterial disease testing. Vasc Med 1(1):65–71
Darling RC, Raines JK, Brener BJ, Austen WG (1972) Quantitative segmental pulse volume recorder: a clinical tool. Surgery 72(6):873–877
Dawson DL, Cutler BS, Meissner MH, Strandness DE Jr (1998) Cilostazol has beneficial effects in treatment of intermittent claudication: results from a multicenter, randomized, prospective, double-blinded trial. Circulation 98(7):678–686
de Groot E, Jukema JW, Montauban van Swijndregt AD, Zwinderman AH, Ackerstaff RG, van der Steen AF, Bom N, Lie KI, Bruschke AV (1998) B-mode ultrasound assessment of pravastatin treatment effect on carotid and femoral artery walls and its correlations with coronary arteriographic findings: a report of the Regression Growth Evaluation Statin Study (REGRESS). J Am Coll Cardiol 31:1561–1567
Diehm C, Allenberg JR, Pittrow D, Mahn M, Tepohl G, Haberl RL, Darius H, Burghaus I, Trampisch HJ, German Epidemiological Trial on Ankle Brachial Index Study Group (2009) Mortality and vascular morbidity in older adults with asymptomatic versus symptomatic peripheral artery disease. Circulation 120:2053–2061
Dieter RS, Dieter RA, Dieter RA (2009) Peripheral arterial disease. McGraw-Hill, New York
Dieter RS, Dieter RA, Dieter RA (2014) Endovascular interventions. A case-based approach. Springer, New York
Erez G, Leitersdorf E (2007) The rationale for using HMG-CoA reductase inhibitors (“statins”) in peripheral arterial disease. Eur J Vasc Endovasc Surg 33(2):192–201
Faulkner KW, House AK, Castleden WM (1983) The effect of cessation of smoking on the accumulative survival rates of patients with symptomatic peripheral vascular disease. Med J Aust 1(5):217–219
Feringa HH, van Waning VH, Bax JJ, Elhendy A, Boersma E, Schouten O, Galal W, Vidakovic RV, Tangelder MJ, Poldermans D (2006) Cardioprotective medication is associated with improved survival in patients with peripheral arterial disease. J Am Coll Cardiol 47(6):1182–1187
Freund KM, Belanger AJ, D’Agostino RB, Kannel WB (1993) The health risks of smoking. The framingham study: 34 years of follow-up. Ann Epidemiol 3:417–424
Fuster VF, Alexander RW, O’Rouke RA, Robert R, King SB III, Wellens HJ (2001) Hurst’s the heart. McGraw-Hill, New York
Gardner AW, Poehlman ET (1995) Exercise rehabilitation programs for the treatment of claudication pain: a meta-analysis. JAMA 274:975–980
Gargiulo G, Giugliano G, Esposito G (2012) Use of statins in lower extremity disease: a review. BMC Surg 12(Suppl 1):S15
Gerhard-Herman M, Gardin JM, Jaff M, Mohler E, Roman M, Naqvi TZ (2006) Guidelines for noninvasive vascular laboratory testing: a report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology. J Am Soc Echocardiogr 19:955–972
Hammer A, Steiner S (2013) Gene therapy for therapeutic angiogenesis in peripheral arterial disease – a systematic review and meta-analysis of randomized, controlled trials. Vasa 42(5):331–339
Heart Protection Study Collaborative Group (2002) MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20, 536 high-risk individuals: a randomized placebo-controlled trial. Lancet 360(9326):7–22
Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, Krook SH, Hunninghake DB, Comerota AJ, Walsh ME, McDermott MM, Hiatt WR (2001a) Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 286(11):1317–1324
Hirsch AT, Hiatt WR, PARTNERS Steering Committee (2001b) PAD awareness, risk and treatment: new resources for survival – the USA PARTNERS program. Vasc Med 6(Suppl 3):9–12
Hoogeveen EK, Mackaay AJ, Beks PJ, Kostense PJ, Dekker JM, Heine RJ, Nijpels G, Rauwerda JA, Stehouwer CD (2008) Evaluation of the one-minute exercise test to detect peripheral arterial disease. Eur J Clin Invest 38(5):290–295
Hummel BW, Hummel BA, Mowbry A, Maixner W, Barnes RW (1978) Reactive hyperemia vs. treadmill exercise testing in arterial disease. Arch Surg 113:95–98
Jonason T, Bergstrom R (1987) Cessation of smoking in patients with intermittent claudication. Effects on the risk of peripheral vascular complications, myocardial infarction and mortality. Acta Med Scand 221:253–260
Leng GC, Fowkes FG (1992) The Edinburgh Claudication Questionnaire: an improved version of the WHO/Rose Questionnaire for use in epidemiological surveys. J Clin Epidemiol 45(10):1101–1109
Marso SP, Hiatt WR (2006) Peripheral arterial disease in patients with diabetes. J Am Coll Cardiol 47:921–929
McPhail IR, Spittell PC, Weston SA, Bailey KR (2001) Intermittent claudication: an objective office-based assessment. J Am Coll Cardiol 37(5):1831–1835
Mills EJ, Wu P, Spurden D, Ebbert JO, Wilson K (2009) Efficacy of pharmacotherapies for short-term smoking abstinence: a systematic review and meta-analysis. Harm Reduct J 6:25
Momsen AH, Jensen MB, Norager CB, Madsen MR, Vestersgaard-Andersen T, Lindholt JS (2009) Drug therapy for improving walking distance in intermittent claudication: a systematic review and meta-analysis of robust randomised controlled studies. Eur J Vasc Endovasc Surg 38(4):463–474
Money SR, Herd JA, Isaacsohn JL, Davison M, Cutler B, Heckman J, Forbes WP (1998) Effect of cilostazol on walking distances in patients with intermittent claudication caused by peripheral vascular disease. J Vasc Surg 27(2):267–274
Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, TASC II Working Group (2007) Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 45:S5–S67
Ouriel K, McDonnell AE, Metz CE, Zarins CK (1982) Critical evaluation of stress testing in the diagnosis of peripheral vascular disease. Surgery 91(6):686–693
Overlack A, Adamczak M, Bachmann W, Bonner G, Bretzel RG, Derichs R, Krone W, Lederle RM, Reimann HF, Zschiedrich H (1994) ACE-inhibition with perindopril in essential hypertensive patients with concomitant diseases. The Perindopril Therapeutic Safety Collaborative Research Group. Am J Med 97(2):126–134
Quick CR, Cotton LT (1982) The measured effect of stopping smoking on intermittent claudication. Br J Surg 69(Suppl):S24–S26
Radack K, Deck C (1991) Beta-adrenergic blocker therapy does not worsen intermittent claudication in subjects with peripheral arterial disease. A meta-analysis of randomized controlled trials. Arch Intern Med 151(9):1769–1776
Robless P, Michailidis DP, Stansby GP (2008) Cilostazol for peripheral arterial disease. Cochrane Database Syst Rev 1, CD003748
Rumwell C, McPharlin M (2004) Vascular technology, 3rd edn. Davies, Pasadena
Rutherford RB, Lowenstein DH, Klein MF (1979) Combining segmental systolic pressures and plethysmography to diagnose arterial occlusive disease of the legs. Am J Surg 138(2):211–218
Rutherford RB, Baker DJ, Ernst CE, Johnston KW, Porter JM, Ahn S, Jones DN (1997) Recommended standards for reports dealing with lower extremity ischemia: a revised version. J Vasc Surg 26(3):517–538
Salhiyyah K, Senanayake E, Abdel-Hadi M, Booth A, Michaels JA (2012) Pentoxifylline for intermittent claudication. Cochrane Database Syst Rev 1, CD005262
Stewart KJ, Hiatt WR, Regensteiner JG, Hirsch AT (2002) Exercise training for claudication. N Engl J Med 347:1941–1951
The AIM-HIGH Investigators (2011) Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 365:2255–2267
The Heart Outcomes Prevention Evaluation (HOPE) Study Investigators (2000) Effects of angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 342:145–153
UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853
United States Preventive Services Task Force (2005) Recommendation statement: screening for peripheral arterial disease. Agency for Healthcare Research and Quality, Washington, DC, pp 1–8
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Salman, T., O’Keefe, C., Dieter, R.S. (2015). Atherosclerotic Peripheral Artery Disease: Clinical Management. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_111
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