Peripheral arterial disease: Epidemiology, natural history, diagnosis and treatment

Abstract

Lower extremity peripheral arterial disease (PAD) affects approximately 10% of the American population, with 30% to 40% of these patients presenting with claudication symptoms. The prevalence of PAD increases with age and the number of vascular risk factors. More importantly, it is a marker of atherosclerotic disease burden, and is associated with increased mortality from cardiovascular and cere- brovascular causes. There have been recent advances in noninvasive imaging, endovascular approaches for revascularization, and aggressive risk factor management for prevention of cardiac and cere- brovascular complications in PAD. There is now a trend toward aggressive risk factor modification and endovascular revascularization for most patients, with surgical interventions reserved for certain situations only. In the present article, a systematic review is presented, focusing on the key aspects of the disease epidemiology, presentation, natural history, diagnosis and available management options.