PMID- 37914901
OWN - NLM
STAT- Publisher
LR  - 20231102
IS  - 1573-7241 (Electronic)
IS  - 0920-3206 (Linking)
DP  - 2023 Nov 2
TI  - Contemporary Medical Management of Peripheral Arterial Disease.
LID - 10.1007/s10557-023-07516-2 [doi]
AB  - PURPOSE: Peripheral arterial disease (PAD) is characterized by atherosclerotic 
      arterial occlusive disease of the lower extremities and is associated with an 
      increased risk of major adverse cardiovascular events (MACE) in addition to 
      disabling clinical sequelae, including intermittent claudication and chronic 
      limb-threatening ischemia (CLTI). Given the growing burden of disease, knowledge 
      of modern practices to prevent MACE and major adverse limb events (MALE) is 
      essential. This review article examines evidence for medical management of PAD 
      and its associated risk factors, as well as wound prevention and care. METHODS: A 
      thorough review of the literature was performed, with attention to evidence for 
      the management of modifiable atherosclerotic risk factors, claudication symptoms, 
      wound prevention, and wound care. RESULTS: Contemporary management of PAD 
      requires a multi-faceted approach to care, with medical optimization of smoking, 
      hypertension, hyperlipidemia, and diabetes mellitus. The use of supervised 
      exercise therapy for intermittent claudication is highlighted. The anatomic 
      disease patterns of smoking and diabetes mellitus are discussed further, and best 
      practices for diabetic foot ulcer prevention, including offloading footwear, are 
      described. Quality wound care is essential in this patient population and 
      involves strategic use of debridement, wound-healing adjuncts, and skin 
      substitutes, when appropriate. CONCLUSION: The objective of medical management of 
      PAD is to reduce the risk of MACE and MALE. Atherosclerotic risk factor 
      optimization, appropriate wound care, and management of diabetic foot ulcers, 
      foot infections, gangrene, and chronic, non-healing wounds are critical 
      components of PAD care. Interdisciplinary care is essential to coordinate care, 
      leverage expertise, and improve outcomes.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Cook, Ian O
AU  - Cook IO
AD  - Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey 
      Department of Surgery, Baylor College of Medicine, One Baylor Plaza, BCM 390, 
      Houston, TX, 77030, USA.
FAU - Chung, Jayer
AU  - Chung J
AUID- ORCID: 0000-0001-6404-4414
AD  - Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey 
      Department of Surgery, Baylor College of Medicine, One Baylor Plaza, BCM 390, 
      Houston, TX, 77030, USA. jayer.chung@bcm.edu.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231102
PL  - United States
TA  - Cardiovasc Drugs Ther
JT  - Cardiovascular drugs and therapy
JID - 8712220
SB  - IM
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - Claudication
OT  - Critical limb ischemia
OT  - Foot ulcer
OT  - Peripheral artery disease
OT  - Wound care
EDAT- 2023/11/02 06:42
MHDA- 2023/11/02 06:42
CRDT- 2023/11/02 00:38
PHST- 2023/10/14 00:00 [accepted]
PHST- 2023/11/02 06:42 [medline]
PHST- 2023/11/02 06:42 [pubmed]
PHST- 2023/11/02 00:38 [entrez]
AID - 10.1007/s10557-023-07516-2 [pii]
AID - 10.1007/s10557-023-07516-2 [doi]
PST - aheadofprint
SO  - Cardiovasc Drugs Ther. 2023 Nov 2. doi: 10.1007/s10557-023-07516-2.