Campia U, Gerhard-Herman M, Piazza G, Goldhaber SZ, et al.
The American journal of medicine. Date of publication 2019 Oct 1;volume 132(10):1133-1141.
1. Am J Med. 2019 Oct;132(10):1133-1141. doi: 10.1016/j.amjmed.2019.04.043. Epub
2019 May 29.
Peripheral Artery Disease: Past, Present, and Future.
Campia U(1), Gerhard-Herman M(2), Piazza G(2), Goldhaber SZ(2).
Author information:
(1)Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital,
Boston, Mass; Harvard Medical School, Boston. Electronic address:
ucampia@bwh.harvard.edu.
(2)Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital,
Boston, Mass; Harvard Medical School, Boston.
Peripheral artery disease is a prevalent but underdiagnosed manifestation of
atherosclerosis. There is insufficient awareness of its clinical manifestations,
including intermittent claudication and critical limb ischemia and of its risk of
adverse cardiovascular and limb outcomes. In addition, our inadequate knowledge
of its pathophysiology has also limited the development of effective treatments,
particularly in the presence of critical limb ischemia. This review aims to
highlight essential elements of the epidemiology and pathophysiology of
peripheral artery disease, bring attention to the often-atypical manifestations
of occlusive arterial disease of the lower extremity, increase awareness of
critical limb ischemia, briefly describe the diagnostic role of the ankle
brachial index, and go over the contemporary management of peripheral artery
disease. An emphasis is placed on evidence-based medical treatments to improve
symptoms and quality of life and to reduce the risk of cardiovascular and limb
events in these patients, including supervised exercise training, smoking
cessation, antagonism of the renin-angiotensin system, lipid-lowering,
antiplatelet, and antithrombotic therapies.
Copyright © 2019 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.amjmed.2019.04.043
PMID: 31150643 [Indexed for MEDLINE]