Kiernan Thomas J, Hynes Brian G, Ruggiero Nicholas J, Yan Bryan P, Jaff Michael R
Section of Vascular Medicine, Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA.
Tech Vasc Interv Radiol. 2010 Mar;13(1):2-10. doi: 10.1053/j.tvir.2009.10.002.
Peripheral artery disease (PAD) is a highly prevalent atherosclerotic syndrome associated with significant morbidity and mortality. PAD is defined by atherosclerotic obstruction of the arteries to the legs that reduce arterial flow during exercise or at rest, and is associated with systemic atherosclerosis. The clinical presentation of PAD is quite varied, including patients with atypical leg symptoms, classic intermittent claudication, and critical limb ischemia. Clinical assessment of these patients includes a comprehensive history, physical examination, and noninvasive and invasive vascular studies. The major risk factors for PAD include diabetes mellitus, tobacco abuse, hyperlipidemia, hypertension, and advanced age. Because of the presence of these risk factors, the systemic nature of atherosclerosis, and the high risk of ischemic events, patients with PAD should be candidates for comprehensive secondary prevention strategies, including aggressive glycemic control, all attempts at tobacco cessation, lipid lowering and antihypertensive treatment, antiplatelet therapy, and thorough foot care. This article reviews the comprehensive diagnostic algorithm and medical treatment strategies for patients with infrainguinal PAD.
外周动脉疾病（PAD）是一种高度流行的动脉粥样硬化综合征，与显著的发病率和死亡率相关。PAD的定义是腿部动脉发生动脉粥样硬化性阻塞，导致运动或休息时动脉血流减少，且与全身性动脉粥样硬化有关。PAD的临床表现多种多样，包括有非典型腿部症状的患者、典型的间歇性跛行患者以及严重肢体缺血患者。对这些患者的临床评估包括全面的病史、体格检查以及非侵入性和侵入性血管检查。PAD的主要危险因素包括糖尿病、吸烟、高脂血症、高血压和高龄。由于存在这些危险因素、动脉粥样硬化的全身性以及缺血事件的高风险，PAD患者应成为全面二级预防策略的适用对象，包括积极控制血糖、所有戒烟尝试、降脂和抗高血压治疗、抗血小板治疗以及全面的足部护理。本文综述了股腘以下PAD患者的综合诊断算法和药物治疗策略。
