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New Treatments for Peripheral Arterial Disease

Peripheral arterial disease is characterized by intermittent claudication, consisting of exercise-induced lower extremity pain that is relieved by rest. Claudication occurs when the blood supply is inadequate to meet the demand of lower limb muscles as a result of atherosclerotic arterial stenosis.

Pathophysiology

The incidence of intermittent claudication rises sharply between ages 50 and 75 years, particularly in persons with coronary artery disease.

This condition affects at least 10% of Peripheral Arterial Disease persons over 70 years of age and 2% of those 37-69 years of age with intermittent claudication

Risk factors

Cigarette smoking is the most important risk factor for PAD. 70-90% of patients with arterial insufficiency are smokers. Risk remains increased for up to 5 years after smoking cessation.

Other risk factors include hyperlipidemia, diabetes mellitus, and hypertension.

After five-years, 4% of patients with claudication lose a limb and 16% have worsening claudication or limb-threatening ischemia.

The five-year mortality rate for patients with claudication is 29%; 60% of deaths result from coronary artery disease, 15% from cerebrovascular disease, and the remainder result from nonatherosclerotic.

Clinical Evaluation of Intermittent Claudication

Evaluation consists of determining the location, extent, and severity of disease and the degree of functional impairment of intermittent claudication.

The key clinical features of claudication are reproducibility of muscular pain in the thigh or calf after a given level of activity.