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Review
. 2025 Oct;44(5):383-390.
doi: 10.23736/S0392-9590.25.05302-7. Epub 2025 Apr 3.

Smoking and lower extremity artery disease

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Free article
Review

Smoking and lower extremity artery disease

Pier L Antignani et al. Int Angiol. 2025 Oct.
Free article

Abstract

Cigarette smoking is a major preventable risk factor for lower extremity arterial disease (LEAD) and is strongly associated with a higher risk of disease progression, worse post-procedural outcomes, and increased healthcare utilization. Smoking provokes the development of atherosclerotic through different mechanisms. Endothelial cell dysfunction, oxidative stress, inflammation, and arterial stiffness are among the key factors related to the development of atherogenesis due to smoking. Smoking cessation among patients with LEAD and the use of smoking cessation methods, including pharmacological treatment, are mandatory. Given that smoking cessation interventions remain underutilized. Therefore, in this narrative review we highlight the importance of incorporating smoking cessation treatments as part of the medical management of LEAD. Regulatory approaches to reduce tobacco use and support smoking cessation have the potential to reduce the burden of LEAD.

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