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Optimal management of infrainguinal arterial occlusive disease

Authors Pennywell DJ, Tan T, Zhang WW

Received 21 July 2014

Accepted for publication 26 August 2014

Published 24 October 2014 Volume 2014:10 Pages 599—608

DOI https://doi.org/10.2147/VHRM.S50779

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Daniel Duprez


David J Pennywell, Tze-Woei Tan, Wayne W Zhang

Division of Vascular and Endovascular Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA

Abstract: Peripheral arterial occlusive disease is becoming a major health problem in Western societies as the population continues to age. In addition to risk of limb loss, the complexity of the disease is magnified by its intimate association with medical comorbidity, especially cardiovascular and cerebrovascular disease. Risk factor modification and antiplatelet therapy are essential to improve long-term survival. Surgical intervention is indicated for intermittent claudication when a patient's quality of life remains unacceptable after a trial of conservative therapy. Open reconstruction and endovascular revascularization are cornerstone for limb salvage in patients with critical limb ischemia. Recent advances in catheter-based technology have made endovascular intervention the preferred treatment approach for infrainguinal disease in many cases. Nevertheless, lower extremity bypass remains an important treatment strategy, especially for reasonable risk patients with a suitable bypass conduit. In this review, we present a summary of current knowledge about peripheral arterial disease followed by a review of current, evidence-based medical and surgical therapy for infrainguinal arterial occlusive disease.

Keywords: peripheral vascular disease, peripheral arterial disease, critical limb ischemia, claudication, infrainguinal bypass, endovascular infrainguinal intervention
 

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