Overview
Peripheral arterial disease is usually caused by atherosclerosis affecting arteries supplying the lower limbs.
Clinical Features
Intermittent claudication causes exertional limb pain relieved by rest. Advanced disease may cause rest pain, ulceration, or tissue loss.
Examination may reveal absent pulses, cool skin, trophic changes, or delayed capillary refill.
Investigation
The ankle-brachial pressure index is a common initial physiological test, with vascular imaging used when intervention is being considered or the diagnosis is unclear.
Management
Management includes smoking cessation, exercise therapy, lipid and blood-pressure control, antithrombotic therapy when indicated, and revascularization for selected symptomatic disease.
Clinical Pearls
PAD is both a limb disease and a marker of systemic atherosclerosis.
END OF REVIEW
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