On completion of the chapter, the reader will be able to:
Compare and contrast the reported prevalence rates for peripheral arterial disease (PAD) using patient self-report, clinical assessment, and objective measures such as the ankle-brachial index (ABI).
Describe how the diagnosis of PAD is made, considering history, physical findings, and clinical testing.
Write goals of therapy in the management of PAD, including goals for blood flow, walking distance, and management of modifiable risk factors.
Provide recommendations for smoking cessation and exercise for PAD patients, and outline when patients should be referred for surgical or catheter-based interventions.
Describe goals of therapy for the management of the risk factors for PAD including hypertension, hyperlipidemia, and diabetes.
Outline the rationale for antiplatelet therapy, and summarize the evidence for efficacy of aspirin, aspirin plus dipyridamole, clopidogrel, and ticlopidine in modifying vascular end points in PAD patients.
Describe the potential role for cilostazol and pentoxifylline in the management of intermittent claudication.
Peripheral arterial disease (PAD), the most common form of peripheral vascular disease, is a manifestation of progressive narrowing of arteries due to atherosclerosis.1 PAD is associated with elevated risk of cardiovascular disease (CVD) morbidity and mortality, even in the absence of prior history of acute myocardial infarction (AMI), stroke, or other manifestations of CVD.2 Patients with PAD have approximately the same relative risk of death from CVD as do patients with a history of coronary or cerebrovascular disease, and PAD should be considered a surrogate marker of subclinical coronary artery disease (CAD) and ...