Epidemiology
Etiology
- Atherosclerosis in the aorta and peripheral arteries → insufficient tissue perfusion → PAD
- PAD usually coexists with coronary artery disease. Smoking is one of the most important risk factors for PAD!
Pathophysiology
Clinical features
- Intermittent claudication
- Femoropopliteal disease (most common): typically causes calf claudication
- Aortoiliac disease (Leriche syndrome)
- Level of the aortic bifurcation or bilateral occlusion of the iliac arteries
- Triad of bilateral buttock, hip, or thigh claudication, erectile dysfunction, and absent/diminished femoral pulses
- Worsens upon exertion
- Due to increased oxygen demand
Diagnostics
Treatment
Vasodilator therapy
- Indications
- Intermittent claudication to improve symptoms and functional status
- May be considered after revascularization of femoropopliteal disease to reduce the risk of re-stenosis
- Agent: cilostazol (a phosphodiesterase type 3 inhibitor with vasodilatory, antiplatelet, and antithrombotic properties)