User:Mr. Ibrahem/Peripheral artery disease

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Peripheral artery disease
Other namesPeripheral vascular disease (PVD), peripheral artery occlusive disease, peripheral obliterative arteriopathy
An arterial insufficiency ulcer in a person with severe peripheral artery disease[1]
SpecialtyInterventional radiology, vascular surgery
SymptomsLeg pain when walking which resolves with rest, skin ulcers, bluish skin, cold skin[2][3]
ComplicationsInfection, amputation[4]
CausesAtherosclerosis, artery spasm[5][6]
Risk factorsCigarette smoking, diabetes, high blood pressure, high blood cholesterol.[4][7]
Diagnostic methodAnkle-brachial index < 0.90, duplex ultrasonography, angiography[8][9]
TreatmentStopping smoking, supervised exercise therapy, surgery[10][11][12]
MedicationStatins, ACE inhibitors, cilostazol[12]
Frequency155 million (2015)[13]
Deaths52,500 (2015)[14]

Peripheral artery disease (PAD) is an abnormal narrowing of arteries other than those that supply the heart or brain.[5][15] When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular disease.[4] Peripheral artery disease most commonly affects the legs, but other arteries may also be involved – such as those of the arms, neck, or kidneys.[4][16] The classic symptom is leg pain when walking which resolves with rest, known as intermittent claudication.[2] Other symptoms include skin ulcers, bluish skin, cold skin, or abnormal nail and hair growth in the affected leg.[3] Complications may include an infection or tissue death which may require amputation; coronary artery disease, or stroke.[4] Up to 50% of people with PAD do not have symptoms.[2]

The greatest risk factor for PAD is cigarette smoking.[4] Other risk factors include diabetes, high blood pressure, kidney problems, and high blood cholesterol.[7][17] The most common underlying mechanism of peripheral artery disease is atherosclerosis, especially in individuals over 40 years old.[6][18] Other mechanisms include artery spasm, blood clots, trauma, fibromuscular dysplasia, and vasculitis.[5][17] PAD is typically diagnosed by finding an ankle-brachial index (ABI) less than 0.90, which is the systolic blood pressure at the ankle divided by the systolic blood pressure of the arm.[9] Duplex ultrasonography and angiography may also be used.[8] Angiography is more accurate and allows for treatment at the same time; however, it is associated with greater risks.[9]

It is unclear if screening for peripheral artery disease in people without symptoms is useful as it has not been properly studied.[19][20][18] In those with intermittent claudication, stopping smoking and supervised exercise therapy improve outcomes.[11][12][21] Medications, including statins, ACE inhibitors, and cilostazol may also help.[12][22] Aspirin does not appear to help those with mild disease but is usually recommended in those with more significant disease due to the increased risk of heart attacks.[18][23][24] Anticoagulants such as warfarin are not typically of benefit.[25] Procedures used to treat the disease include bypass grafting, angioplasty, and atherectomy.[10]

In 2015, about 155 million people had PAD worldwide.[13] It becomes more common with age.[26] In the developed world, it affects about 5.3% of 45- to 50-year-olds and 18.6% of 85- to 90-year-olds.[7] In the developing world, it affects 4.6% of people between the ages of 45 and 50 and 15% of people between the ages of 85 and 90.[7] PAD in the developed world is equally common among men and women, though in the developing world, women are more commonly affected.[7] In 2015 PAD resulted in about 52,500 deaths, which is an increase from the 16,000 deaths in 1990.[14][27]

References[edit]

  1. ^ Moore, Jonathan (1 September 2008). "Creating the Ideal Microcosm for Rapid Incorporation of Bioengineered Alternative Tissues Using An Advanced Hydrogel Impregnated Gauze Dressing: A Case Series". The Foot & Ankle Journal. doi:10.3827/faoj.2008.0109.0002.
  2. ^ a b c Violi, F; Basili, S; Berger, JS; Hiatt, WR (2012). Antiplatelet therapy in peripheral artery disease. Vol. 210. pp. 547–63. doi:10.1007/978-3-642-29423-5_22. ISBN 978-3-642-29422-8. PMID 22918746. {{cite book}}: |journal= ignored (help)
  3. ^ a b "What Are the Signs and Symptoms of Peripheral Arterial Disease?". nhlbi.nih.gov. August 2, 2011. Archived from the original on February 25, 2015. Retrieved February 26, 2015.
  4. ^ a b c d e f "What Is Peripheral Arterial Disease?". nhlbi.nih.gov. August 2, 2011. Archived from the original on February 25, 2015. Retrieved February 25, 2015.
  5. ^ a b c "What Is Peripheral Vascular Disease?" (PDF). American Heart Association (heart.org). 2012. Archived (PDF) from the original on April 12, 2015. Retrieved February 26, 2015. Peripheral artery disease (PAD) is the narrowing of the arteries to the legs, stomach, arms and head.
  6. ^ a b "What Causes Peripheral Arterial Disease?". nhlbi.nih.gov. August 2, 2011. Archived from the original on February 25, 2015. Retrieved February 26, 2015.
  7. ^ a b c d e Fowkes, FG; Rudan, D; Rudan, I; Aboyans, V; Denenberg, JO; McDermott, MM; Norman, PE; Sampson, UK; Williams, LJ; Mensah, GA; Criqui, MH (19 October 2013). "Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis". Lancet. 382 (9901): 1329–40. doi:10.1016/s0140-6736(13)61249-0. PMID 23915883.
  8. ^ a b "How Is Peripheral Arterial Disease Diagnosed?". August 2, 2011. Archived from the original on April 7, 2015. Retrieved March 27, 2015.
  9. ^ a b c Ruiz-Canela, M; Martínez-González, MA (2014). "Lifestyle and dietary risk factors for peripheral artery disease". Circulation Journal. 78 (3): 553–9. doi:10.1253/circj.cj-14-0062. PMID 24492064.
  10. ^ a b "How Is Peripheral Arterial Disease Treated?". nhlbi.nih.gov. August 2, 2011. Archived from the original on February 25, 2015. Retrieved February 26, 2015.
  11. ^ a b Hageman, D; Fokkenrood, HJ; Gommans, LN; van den Houten, MM; Teijink, JA (6 April 2018). "Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication". The Cochrane Database of Systematic Reviews. 4: CD005263. doi:10.1002/14651858.CD005263.pub4. PMC 6513337. PMID 29627967.
  12. ^ a b c d Hankey, GJ; Norman, PE; Eikelboom, JW (1 February 2006). "Medical treatment of peripheral arterial disease". JAMA. 295 (5): 547–53. doi:10.1001/jama.295.5.547. PMID 16449620.
  13. ^ a b GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
  14. ^ a b GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
  15. ^ "Overview of Peripheral Arterial Disease – Heart and Blood Vessel Disorders". Merck Manuals Consumer Version. Archived from the original on April 30, 2019. Retrieved 30 April 2019. Disorders of arteries that supply the brain with blood are considered separately as cerebrovascular disease.
  16. ^ Shantulli, Shu (2018). "Update on peripheral arterial disease: Epidemiology and evidence-based facts". Atherosclerosis.
  17. ^ a b Harrison's principles of internal medicine (20 ed.). McGraw-Hill Education / Medical. 2018. ISBN 9781259644047.
  18. ^ a b c Gerhard-Herman, MD; Gornik, HL; Barrett, C; Barshes, NR; Corriere, MA; Drachman, DE; Fleisher, LA; Fowkes, FG; Hamburg, NM; Kinlay, S; Lookstein, R; Misra, S; Mureebe, L; Olin, JW; Patel, RA; Regensteiner, JG; Schanzer, A; Shishehbor, MH; Stewart, KJ; Treat-Jacobson, D; Walsh, ME (21 March 2017). "2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Journal of the American College of Cardiology. 69 (11): 1465–1508. doi:10.1016/j.jacc.2016.11.008. PMID 27851991.
  19. ^ Andras, A; Ferket, B (Apr 7, 2014). "Screening for peripheral arterial disease". The Cochrane Database of Systematic Reviews. 4 (4): CD010835. doi:10.1002/14651858.CD010835.pub2. PMID 24711093.
  20. ^ U.S. Preventive Services Task Force (December 15, 2014). "Peripheral artery disease screening and cardiovascular disease risk assessment with the ankle-brachial index in adults: recommendation statement". Am Fam Physician. 90 (12): 858A–858D. Archived from the original on March 31, 2017.
  21. ^ Ton, Joey (24 January 2022). "#307 Walking it off: How effective is exercise for management of peripheral artery disease?". CFPCLearn. Archived from the original on 1 July 2023. Retrieved 14 June 2023.
  22. ^ Bedenis, R; Stewart, M; Cleanthis, M; Robless, P; Mikhailidis, DP; Stansby, G (31 October 2014). "Cilostazol for intermittent claudication". The Cochrane Database of Systematic Reviews. 10 (10): CD003748. doi:10.1002/14651858.CD003748.pub4. PMC 7173701. PMID 25358850.
  23. ^ Lin, JS; Olson, CM; Johnson, ES; Whitlock, EP (3 September 2013). "The ankle-brachial index for peripheral artery disease screening and cardiovascular disease prediction among asymptomatic adults: a systematic evidence review for the U.S. Preventive Services Task Force". Annals of Internal Medicine. 159 (5): 333–41. doi:10.7326/0003-4819-159-5-201309030-00007. PMID 24026319.
  24. ^ Poredos, P; Jezovnik, MK (March 2013). "Is aspirin still the drug of choice for management of patients with peripheral arterial disease?". VASA. Zeitschrift für Gefässkrankheiten. 42 (2): 88–95. doi:10.1024/0301-1526/a000251. PMID 23485835.
  25. ^ Hauk, L (15 May 2012). "ACCF/AHA update peripheral artery disease management guideline". American Family Physician. 85 (10): 1000–1. PMID 22612053.
  26. ^ Vascular medicine : a companion to Braunwald's heart disease. Creager, Mark A., Beckman, Joshua A., Loscalzo, Joseph. (2nd ed.). Philadelphia, PA: Elsevier/Saunders. 2013. ISBN 9781455737369. OCLC 810335904.{{cite book}}: CS1 maint: others (link)
  27. ^ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
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