Ramona Matusevičiūtė1, Dominykas Kaupas1, Rytis Stasys Kaupas2
1 Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania
2 Lithuanian University of Health Sciences Kaunas Clinics, Radiology Clinic, Department of Interventional Radiology, Kaunas, Lithuania
Introduction. Atherosclerotic disease often involves arteries that supply blood to the lower extremities and is called peripheral arterial disease (PAD). Despite its severe consequences PAD is still receiving little public attention, although it is the third leading manifestation of atherosclerotic cardiovascular disease after coronary heart disease and stroke.
Aim: to review the epidemiology, risk factors, clinical symptoms, diagnostic methods and endovascular treatment options for PAD.
Materials and methods. A literature review was performed using PubMed database and UpToDate clinical sources. Keywords used in the article search were: “peripheral artery disease”, “atherosclerotic disease”, “lower extremity ischemia”, “endovascular treatment”, “percutaneous transluminal angioplasty”.
Results. The most common risk factors for PAD are older age, male gender, smoking, arterial hypertension (AH), diabetes mellitus (DM), hyperlipidaemia, African American race and family history of atherosclerosis. The main clinical symptoms of this disease are intermittent claudication, atypical limb pain, non-healing wounds, ulcers or gangrene in the lower extremities. Symptomatic patients are diagnosed with PAD using peripheral pulse palpation and calculation of ankle-brachial index (ABI), while complex visual vascular imaging is used in cases of uncertainty. Endovascular therapy may be indicated for patients who are unable to control PAD with conservative treatment.
Conclusions. The most common PAD risk factors are smoking, AH, DM, hyperlipidaemia and most frequent symptoms are intermittent claudication, atypical limb pain and non-healing wounds. Palpation of peripheral pulses and measurement of ABI are required in the diagnosis of PAD. In case of failure of conservative treatment of PAD, endovascular treatment could be indicated.
Keywords: peripheral artery disease, endovascular treatment, atherosclerotic disease, lower extremity ischemia, intermittent claudication, percutaneous transluminal angioplasty, stenting