Evidence-Based Medical Management of Peripheral Artery Disease

Arterioscler Thromb Vasc Biol. 2020 Mar;40(3):541-553. doi: 10.1161/ATVBAHA.119.312142. Epub 2020 Jan 30.

Abstract

Peripheral artery disease is an atherosclerotic disease of the lower extremities associated with high cardiovascular mortality. Management of this condition may include lifestyle modifications, medical management, endovascular repair, or surgery. The medical approach to peripheral artery disease is multifaceted and includes cholesterol reduction, antiplatelet therapy, anticoagulation, peripheral vasodilators, blood pressure management, exercise therapy, and smoking cessation. Adherence to this regimen can reduce limb-related complications like critical limb ischemia and amputation, as well as systemic complications of atherosclerosis like stroke and myocardial infarction. Relative to coronary artery disease, peripheral artery disease is an undertreated condition. In this article, we explore the evidence behind medical therapies for the management of peripheral artery disease.

Keywords: atherosclerosis; blood pressure; cardiovascular disease; cholesterol; peripheral artery disease; stroke; vascular medicine.

Publication types

  • Review

MeSH terms

  • Amputation, Surgical
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Evidence-Based Medicine*
  • Hemodynamics
  • Humans
  • Limb Salvage
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / mortality
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / therapy*
  • Risk Factors
  • Risk Reduction Behavior*
  • Treatment Outcome
  • Vascular Surgical Procedures* / adverse effects

Substances

  • Cardiovascular Agents