Medical Management of Peripheral Artery Disease

Abstract

Peripheral artery disease (PAD) is a common type of atherosclerotic disease of the lower extremities associated with reduced quality of life and ambulatory capacity. Major adverse cardiovascular events and limb amputations are the leading cause of morbidity and mortality in this population. Optimal medical therapy is therefore critical in these patients to prevent adverse events. Risk factor modifications, including blood pressure control and smoking cessation, in addition to antithrombotic agents, peripheral vasodilators, and supervised exercise therapy are key pillars of medical therapy. Revascularization procedures represent key touch points between patients and health care providers and serve as opportunities to optimize medical therapy and improve long-term patency rates and outcomes. This review summarizes the aspects of medical therapy that all providers should be familiar with when caring for patients with PAD in the peri-revascularization period.

Keywords: antithrombotic therapy; interventional radiology; medical management; peripheral artery disease; smoking cessation; supervised exercise therapy.

Fig. 1

Postoperative guide for medical optimization of patients with peripheral artery disease after revascularization. BP, blood pressure; DM, diabetes mellitus; MACE, major adverse cardiovascular events; MALE, major adverse limb events.

Fig. 2

Key components of medical management for peripheral artery disease.