[Rational approach to peripheral arterial occlusive diseases].

A growing proportion of over 65-year-old persons in the population will increasingly confront physicians with peripheral arterial occlusive disease. Intermittent claudication is the characteristic symptom of stage II disease at which most patients consult their physician. Known risk factors like cigarette smoking, diabetes, hypertension and hyperlipidemia have to be assessed. Manifestations of atherosclerosis in other vascular beds such as carotids and coronaries should be sought. Clinical angiologic evaluation with inspection, palpation of pulses, auscultation of vessels at rest and after exercise as well as measurement of the walking distance permits assessment of peripheral perfusion quite well. Oscillography and Doppler-sonography are increasingly used. Duplex-scanning can replace angiography in many cases. Conventional and digital subtraction-angiography have their specific uses. Diagnostic and therapeutic measures recommended for peripheral arterial occlusive disease are summarized.