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Peripheral Arterial Disease

Keshav Kukreja, MD, Adrian DaSilva-DeAbreu, MD and Raymundo A. Quintana, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

Peripheral arterial disease (PAD) represents atherosclerotic occlusive disease of the peripheral arteries, most commonly in the lower extremities. Following coronary artery disease a...

DIAGNOSIS

HISTORY

  • Nearly 50% of patients will be asymptomatic.

  • IC seen in 10–30% of patients and is typically self-limiting with symptoms resolving within 2 to 5 minutes of rest

  • Atypical or resting leg p...

TREATMENT

GENERAL MEASURES

  • The treatment of PAD is multifactorial and includes a supervised exercise program, guideline-based medical therapy, and risk factor modification (2).

  • An interdisciplinary appr...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • At follow-up, patients should undergo thorough history and physical examinations. They should be asked about their progress with risk-factor modification (i.e., s...

REFERENCES

1
Gerhard-Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the Amer...

ADDITIONAL READING

  • Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res.  2015;116(9):1509–1526. [View Abstract on OvidMedline]

  • Hiatt WR, Armstrong EJ, Larson CJ, et al. Patho...

CODES

ICD10

  • I73.9 Peripheral vascular disease, unspecified

  • I70.209 Unsp athscl native arteries of extremities, unsp extremity

  • I70.219 Athscl native arteries of extrm w intrmt claud, unsp extrm

  • I70.229 Ath...

CLINICAL PEARLS

  • Consensus on screening for PAD varies. The USPSTF (2013) finds that evidence is insufficient to weigh harms and benefits of screening for PAD.

  • The 2016 AHA/ACC guidelines recommend a th...

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