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Advances in the Management of Peripheral Artery Disease

  • Macrovascular Complications in Diabetes (VR Aroda and A Getaneh, Section Editors)
  • Published:
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Abstract

Purpose of Review

This paper provides a concise update on the management of peripheral artery disease (PAD).

Recent Findings

PAD continues to denote a population at high risk for mortality but represents a threat for limb loss only when associated with foot ulcers, gangrene, or infections. Performing either angiogram or non-invasive testing for all patients with foot ulcers, gangrene, or foot infections will help increase the detection of PAD, and refined revascularization strategies may help optimize wound healing in this patient group. Structured exercise programs are becoming available to more patients with claudication as methods to improve adherence to community-based exercise programs will improve. Finally, ensuring more patients with PAD receive aspirin therapy and statins may improve long-term survival, while further research will help determine if adding newer antiplatelet or anticoagulant medications may reduce leg amputations in selected patients.

Summary

Clinicians should have a low threshold to obtain an angiogram and to pursue revascularization in patients with foot ulcers, gangrene, or foot infections. In patients with claudication, clinicians should maximize the benefits derived from exercise therapy and medical management before offering percutaneous or surgical revascularization.

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Abbreviations

PAD:

Peripheral artery disease

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Authors and Affiliations

  1. Division of Vascular Surgery and Endovascular Therapy, Michael E. Debakey Department of Surgery, Baylor College of Medicine/Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard (OCL 112),, Houston, TX, 77030, USA

    Neal R. Barshes & Courtney L. Grant

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  1. Neal R. Barshes
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Correspondence to Neal R. Barshes.

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This article is part of the Topical Collection on Macrovascular Complications in Diabetes

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Barshes, N.R., Grant, C.L. Advances in the Management of Peripheral Artery Disease. Curr Diab Rep 19, 36 (2019). https://doi.org/10.1007/s11892-019-1155-0

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