Peripheral artery disease: Evolving role of exercise, medical therapy, and endovascular options

Jeffrey W. Olin, Christopher J. White, Ehrin J. Armstrong, Daniella Kadian-Dodov, William R. Hiatt

Research output: Contribution to journalReview articlepeer-review

148 Scopus citations

Abstract

The prevalence of peripheral artery disease (PAD) continues to increase worldwide. It is important to identify patients with PAD because of the increased risk of myocardial infarction, stroke, and cardiovascular death and impaired quality of life because of a profound limitation in exercise performance and the potential to develop critical limb ischemia. Despite effective therapies to lower the cardiovascular risk and prevent progression to critical limb ischemia, patients with PAD continue to be under-recognized and undertreated. The management of PAD patients should include an exercise program, guideline-based medical therapy to lower the cardiovascular risk, and, when revascularization is indicated, an "endovascular first" approach. The indications and strategic choices for endovascular revascularization will vary depending on the clinical severity of the PAD and the anatomic distribution of the disease. In this review, we discuss an evidence-based approach to the management of patients with PAD.

Original languageEnglish
Pages (from-to)1338-1357
Number of pages20
JournalJournal of the American College of Cardiology
Volume67
Issue number11
DOIs
StatePublished - 22 Mar 2016

Keywords

  • ankle-brachial index
  • claudication
  • drug-eluting stents
  • endovascular therapy
  • exercise therapy
  • vascular diseases

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