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下肢外周动脉疾病的当代评估与管理

Contemporary evaluation and management of lower extremity peripheral artery disease.

作者信息

Foley T Raymond, Armstrong Ehrin J, Waldo Stephen W

机构信息

VA Eastern Colorado Healthcare System and Division of Cardiology, University of Colorado, Denver, Colorado, USA.

出版信息

Heart. 2016 Sep 15;102(18):1436-41. doi: 10.1136/heartjnl-2015-309076. Epub 2016 Jun 1.

Abstract

Peripheral artery disease (PAD) includes atherosclerosis of the aorta and lower extremities. Affecting a large segment of the population, PAD is associated with impaired functional capacity and reduced quality of life as well as an increased risk of stroke, myocardial infarction and cardiovascular death. The evaluation of PAD begins with the physical examination, incorporating non-invasive testing such as ankle-brachial indices to confirm the diagnosis. Therapeutic interventions are aimed at alleviating symptoms while preserving limb integrity and reducing overall cardiovascular risk. With this in mind, risk factor modification with exercise and medical therapy are the mainstays of treatment for many patients with PAD. Persistent symptoms or non-healing wounds should prompt more aggressive therapies with endovascular or surgical revascularisation. The following manuscript provides a comprehensive review on the contemporary evaluation and management of PAD.

摘要

外周动脉疾病(PAD)包括主动脉和下肢的动脉粥样硬化。PAD影响着很大一部分人群,与功能能力受损、生活质量下降以及中风、心肌梗死和心血管死亡风险增加相关。PAD的评估始于体格检查,并结合诸如踝臂指数等非侵入性检测来确诊。治疗干预旨在缓解症状,同时保持肢体完整性并降低总体心血管风险。考虑到这一点,通过运动和药物治疗来改变危险因素是许多PAD患者治疗的主要方法。持续的症状或不愈合的伤口应促使采用更积极的治疗方法,如血管内或外科血管重建术。以下手稿对外周动脉疾病的当代评估和管理进行了全面综述。

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