Document Detail


Peripheral artery disease: current insight into the disease and its diagnosis and management.
MedLine Citation:
PMID:  20592174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jeffrey W Olin; Brett A Sealove
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  85     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-07-16     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  678-92     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
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:
0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors; 0/Tetrazoles; 0/Vasodilator Agents; N7Z035406B/cilostazol; SD6QCT3TSU/Pentoxifylline
Comments/Corrections
Comment In:
Mayo Clin Proc. 2010 Nov;85(11):1058-9; author reply 1059-60   [PMID:  21037050 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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