Center for Educational Innovations, Project Quality Research, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
Minerva Med. 2011 Dec;102(6):483-500.
Patients with peripheral arterial disease (PAD) are at increased risk for all-cause mortality, cardiovascular mortality, and mortality from coronary artery disease. Smoking should be stopped and hypertension, dyslipidemia, diabetes mellitus, and hypothyroidism treated. Statins decrease the incidence of intermittent claudication and improve exercise duration until the onset of intermittent claudication in patients with PAD and hypercholesterolemia. The serum low-density lipoprotein cholesterol should be reduced to <70 mg/dL. Antiplatelet drugs such as aspirin or clopidogrel, angiotensin-converting enzyme (ACE) inhibitors, and statins should be given to patients with PAD. Beta blockers should be given if coronary artery disease is present. Cilostazol improves exercise time until intermittent claudication. Exercise rehabilitation programs should be used. Revascularization should be performed if indicated. Patients with an infrarenal or juxtarenal abdominal aortic aneurysm (AAA) measuring 5.5 cm or larger should undergo repair to eliminate the risk of rupture. Patients with an infrarenal or juxtarenal AAA measuring 4.0 to 5.4 cm in diameter should be monitored by ultrasound or computed tomographic scans every 6 to 12 months to detect expansion. Patients with an AAA should undergo intensive risk factor modification, be treated with ACE inhibitors, statins, and beta blockers, and undergo surgery if indicated.
外周动脉疾病（PAD）患者的全因死亡率、心血管死亡率和冠心病死亡率均升高。应戒烟，并治疗高血压、血脂异常、糖尿病和甲状腺功能减退。他汀类药物可降低间歇性跛行的发生率，并改善 PAD 伴高胆固醇血症患者的运动持续时间，直至间歇性跛行发作。血清低密度脂蛋白胆固醇应降至<70mg/dL。应给予 PAD 患者抗血小板药物如阿司匹林或氯吡格雷、血管紧张素转换酶（ACE）抑制剂和他汀类药物。如果存在冠心病，应给予β受体阻滞剂。西洛他唑可改善直至间歇性跛行的运动时间。应使用运动康复计划。如果有指征，应进行血运重建。腹主动脉瘤（AAA）直径测量为 5.5cm 或更大的肾下或肾周 AAA 患者应进行修复，以消除破裂风险。直径为 4.0 至 5.4cm 的肾下或肾周 AAA 患者应每 6 至 12 个月通过超声或计算机断层扫描进行监测，以检测扩张。AAA 患者应进行强化危险因素修正，接受 ACE 抑制剂、他汀类药物和β受体阻滞剂治疗，如果有指征，应进行手术。
