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Medical Management for Chronic Atherosclerotic Peripheral Arterial Disease

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Abstract

The generalized term ‘peripheral vascular disease’ (PVD) may be used to refer to vascular disorders in any non-coronary arterial bed. The more specific term ‘peripheral arterial disease’ (PAD) is used to refer to a more specific process, atherosclerotic disease of the lower extremities. PAD is common. Conservative estimates suggest more than 8 million Americans may be affected by PAD. Since atherosclerosis is a systemic process, PAD should be identified as a coronary heart disease risk equivalent. However, PAD remains an under-diagnosed and under-recognized risk for cardiovascular morbidity and mortality.

PAD symptoms may range from non-specific ambulatory leg complaints, to typical symptoms of intermittent claudication to critical limb ischaemia with rest pain, gangrene or ulceration. These symptoms directly impact quality of life and may affect functional capacity. There are two therapeutic goals for patients with PAD: first, to reduce the risk of cardiovascular events and second, to manage the lower extremity symptoms. This manuscript reviews the medical management of patients with PAD, briefly discussing the goals of cardiovascular risk factor modification and then focusing on pharmacological management strategies for patients with intermittent claudication and critical limb ischaemia.

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Acknowledgements

Farzana Nawaz Ali, MBBS, has no conflicts of interest and received no funding to support the writing of this manuscript. Teresa L. Carman, MD, participates in research funded by Theravasc, Inc. and Aastrom Biosciences. She received no funding to support the writing of this manuscript.

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  1. Department of Family Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA

    Farzana Nawaz Ali

  2. Division of Cardiovascular Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA

    Teresa L. Carman MD

  3. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Teresa L. Carman MD

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Ali, F.N., Carman, T.L. Medical Management for Chronic Atherosclerotic Peripheral Arterial Disease. Drugs 72, 2073–2085 (2012). https://doi.org/10.2165/11640810-000000000-00000

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