Peripheral arterial disease: a literature review

Abstract

Introduction: Peripheral arterial disease (PAD) is a common vascular condition that affects both quality of life and life expectancy with an increased risk of cardiovascular events.

Sources of data: A literature search was carried out of Pub-Med, MEDLINE, the Cochrane Library and Google Scholar from the establishment of these databases up to February 2012. The search was performed by using the keywords 'peripheral arterial disease' and one of the following words: 'management', 'investigations', 'risk factors', 'epidemiology', 'revascularization', 'cryoplasty', 'atherectomy' and 'gene therapy'. Studies were limited to those published in English language.

Areas of agreement: Aggressive risk factors modification is needed to reduce cardiovascular-related mortality in PAD patients.

Areas of controversy: Choice of endovascular or surgical intervention remains controversial in an ever-evolving field.

Growing points: There is a rapid expansion of endovascular technologies aiming to improve the effectiveness of this modality.

Areas timely for developing research: The advances in the fields of gene therapy and therapeutic angiogenesis mean these are potential future treatments. Tissue engineering is a developing area and aims to produce grafts with similar patency and infection profiles to those of autologous material. Further elucidation of the pathophysiology of atherosclerosis is required to provide new targets for pharmacotherapy.