Peripheral Artery Disease Evolving Role of Exercise, Medical Therapy, and Endovascular Options

被引:121
作者
Olin, Jeffrey W. [1 ,2 ]
机构
[1] Icahn Sch Med Mt Sinai, Vasc Med & Vasc Diagnost Lab, Zena & Michael A Wiener Cardiovasc Inst, One Gustave L Levy Pl, New York, NY 10029 USA
[2] Icahn Sch Med Mt Sinai, Marie Josee & Henry R Kravis Ctr Cardiovasc Hlth, One Gustave L Levy Pl, New York, NY 10029 USA
基金
美国国家卫生研究院;
关键词
ankle-brachial index; claudication; drug-eluting stents; endovascular therapy; exercise therapy; vascular diseases; ANKLE-BRACHIAL INDEX; BARE-METAL STENTS; CRITICAL LIMB ISCHEMIA; EXPERT CONSENSUS STATEMENT; PACLITAXEL-COATED BALLOON; SIROLIMUS-ELUTING STENTS; AMPUTATION-FREE SURVIVAL; QUALITY-OF-LIFE; INTERMITTENT CLAUDICATION; SUPERVISED EXERCISE;
D O I
10.1016/j.jacc.2015.12.049
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2016 by the American College of Cardiology Foundation.
引用
收藏
页码:1339 / 1357
页数:19
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