| Peripheral artery disease: current insight into the disease and its diagnosis and management. | |
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MedLine Citation:
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PMID: 20592174 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Peripheral artery disease (PAD), which comprises atherosclerosis of the abdominal aorta, iliac, and lower-extremity arteries, is underdiagnosed, undertreated, and poorly understood by the medical community. Patients with PAD may experience a multitude of problems, such as claudication, ischemic rest pain, ischemic ulcerations, repeated hospitalizations, revascularizations, and limb loss. This may lead to a poor quality of life and a high rate of depression. From the standpoint of the limb, the prognosis of patients with PAD is favorable in that the claudication remains stable in 70% to 80% of patients over a 10-year period. However, the rate of myocardial infarction, stroke, and cardiovascular death in patients with both symptomatic and asymptomatic PAD is markedly increased. The ankle brachial index is an excellent screening test for the presence of PAD. Imaging studies (duplex ultrasonography, computed tomographic angiography, magnetic resonance angiography, catheter-based angiography) may provide additional anatomic information if revascularization is planned. The goals of therapy are to improve symptoms and thus quality of life and to decrease the cardiovascular event rate (myocardial infarction, stroke, cardiovascular death). The former is accomplished by establishing a supervised exercise program and administering cilostazol or performing a revascularization procedure if medical therapy is ineffective. A comprehensive program of cardiovascular risk modification (discontinuation of tobacco use and control of lipids, blood pressure, and diabetes) will help to prevent the latter. |
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Authors:
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Jeffrey W Olin; Brett A Sealove |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 85 ISSN: 1942-5546 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-01 Completed Date: 2010-07-16 Revised Date: 2011-07-19 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: United States |
Other Details:
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Languages: eng Pagination: 678-92 Citation Subset: AIM; IM |
Affiliation:
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Zena and Michael A Wiener Cardiovascular Institute, Marie-Josée and Henry R Kravis Center, Cardiovascular Health, Mount Sinai Medical Center, New York, NY 10029, USA. jeffrey.olin@mountsinai.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ankle Brachial Index Cardiovascular Diseases / etiology, prevention & control Diagnosis, Differential Disease Progression Fibrinolytic Agents / therapeutic use Humans Intermittent Claudication / etiology Magnetic Resonance Angiography Mass Screening / methods Pentoxifylline / therapeutic use Peripheral Vascular Diseases / complications, diagnosis*, epidemiology, therapy* Platelet Aggregation Inhibitors / therapeutic use Prognosis Risk Factors Risk Reduction Behavior Tetrazoles / therapeutic use Tomography, X-Ray Computed Ultrasonography, Doppler, Duplex United States / epidemiology Vasodilator Agents / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors; 0/Tetrazoles; 0/Vasodilator Agents; 6493-05-6/Pentoxifylline; 73963-72-1/cilostazol |
| Comments/Corrections | |
Comment In:
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Mayo Clin Proc. 2010 Nov;85(11):1058-9; author reply 1059-60
[PMID:
21037050
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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