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Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia

Current Treatment Options in Cardiovascular Medicine volume 18, Article number: 42 (2016) Cite this article

Opinion statement

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.

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  1. VA Eastern Colorado Healthcare System and Division of Cardiology, University of Colorado School of Medicine, Denver, CO, USA

    T. Raymond Foley MD, Stephen W. Waldo MD & Ehrin J. Armstrong MD, MSc

Authors
  1. T. Raymond Foley MD
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  2. Stephen W. Waldo MD
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  3. Ehrin J. Armstrong MD, MSc
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Corresponding author

Correspondence to Ehrin J. Armstrong MD, MSc.

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Conflict of Interest

T. Raymond Foley and Stephen W. Waldo each declare no potential conflicts of interest.

Ehrin J. Armstrong reports personal fees from Abbott Vascular, Medtronic, Spectranetics, and Merck.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Disclosures

EJA is a consultant/advisory board member to Abbott Vascular, Medtronic, Merck, and Spectranetics.

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This article is part of the Topical Collection on Vascular Disease

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Foley, T.R., Waldo, S.W. & Armstrong, E.J. Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia. Curr Treat Options Cardio Med 18, 42 (2016). https://doi.org/10.1007/s11936-016-0464-8

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  • DOI: https://doi.org/10.1007/s11936-016-0464-8

Keywords

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