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Management of Peripheral Arterial Disease of the Lower Extremities

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Comprehensive Therapy

Smoking should be stopped and hypertension, diabetes mellitus, dyslipidemia, and hypothyroidism treated in patients with peripheral arterial disease (PAD) of the lower extremities. Statins decrease the incidence of intermittent claudication and improve exercise duration until the onset of intermittent claudication in persons with PAD and hypercholesterolemia. Antiplatelet drugs such as aspirin or clopidogrel, especially clopidogrel, angiotensin-converting enzyme inhibitors, and statins should be given to all persons with PAD. Beta blockers should be given if coronary artery disease is present. Exercise rehabilitation programs and cilostazol increase exercise time until intermittent claudication develops. Chelation therapy should be avoided. Indications for lower extremity percutaneous transluminal angioplasty or bypass surgery are (1) incapacitating claudication in persons interfering with work or lifestyle, (2) limb salvage in persons with limb-threatening ischemia as manifested by rest pain, nonhealing ulcers, and/or infection or gangrene, and (3) vasculogenic impotence.

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  1. Department of Medicine, Divisions of Cardiology, Geriatrics, and Pulmonary/Critical Care, New York Medical College, Valhalla, NY, USA

    Wilbert S. Aronow

  2. Cardiology Division, New York Medical College, Macy Pavilion, Room 138, Valhalla, NY, 10595, USA

    Wilbert S. Aronow

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Correspondence to Wilbert S. Aronow.

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Dr. Aronow has no real or apparent conflicts of interest relating to the subject under discussion.

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Aronow, W.S. Management of Peripheral Arterial Disease of the Lower Extremities. Compr Ther 33, 247–256 (2007). https://doi.org/10.1007/s12019-007-8013-8

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