Vascular medicine: aortic and peripheral arterial disease.

The medical management of patients with an abdominal aortic aneurysm (AAA) includes modification of risk factors, smoking cessation, cardiovascular risk treatment, and hypertensive therapy. No specific therapy has been shown to alter disease outcome. Many AAA and thoracic aortic aneurysms are amenable to endovascular treatment. Endovascular repair offers the benefit of shorter hospital stays and lower perioperative morbidity and mortality. Most patients with peripheral arterial disease (PAD) are asymptomatic or have atypical symptoms; only a few present with classic intermittent claudication or critical limb ischemia. Smoking and diabetes mellitus are the most important risk factors for developing PAD.