title: Peripheral Artery Disease: Evolving Role of Exercise, Medical Therapy, and Endovascular Options.
abstract: 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.
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute & Marie-Joseé and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: jeffrey.olin@mountsinai.org.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Olin
authors.affiliation: Department of Cardiology, Ochsner Clinical School, New Orleans, Louisiana.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: White
authors.affiliation: Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Denver, Colorado, and Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado.
authors.forename: Ehrin J
authors.initials: EJ
authors.lastname: Armstrong
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute & Marie-Joseé and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Daniella
authors.initials: D
authors.lastname: Kadian-Dodov
authors.affiliation: Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, and CPC Clinical Research, Aurora, Colorado.
authors.forename: William R
authors.initials: WR
authors.lastname: Hiatt
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D057510:Endovascular Procedures / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D058729:Peripheral Arterial Disease / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents
keywords: ankle-brachial index; claudication; drug-eluting stents; endovascular therapy; exercise therapy; vascular diseases