Department of Medicine, Mount Sinai Morningside- West, Mount Sinai Health System, New York, USA.
Department of Medicine/Cardiology, Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josée Henry R. Kravis Cardiovascular Health Center, Icahn School of Medicine at the Mount Sinai Hospital, Mount Sinai Heart, New York, NY, USA.
Curr Probl Cardiol. 2024 Apr;49(4):102430. doi: 10.1016/j.cpcardiol.2024.102430. Epub 2024 Feb 1.
The global epidemiological transition of atherosclerotic vascular diseases is witnessing a rapid redistribution of its burden, shifting from high-income to low- and middle-income countries. With a wide clinical spectrum, spanning from intermittent claudication to more complex critical limb threatening ischemia, nonhealing ulcers, gangrene as well as acute limb ischemia, peripheral artery disease is often faced with the challenges of under-diagnosis and under-treatment despite its high prevalence. The management of peripheral arterial disease in patients with multiple comorbidities presents a formidable challenge and remains a pressing global health concern. In this review, we aim to provide an in-depth overview of the pathophysiology of peripheral artery disease and explore evidence-based management strategies encompassing pharmacological, lifestyle, interventional, and surgical approaches. By addressing these challenges, the review contributes to a better understanding of the evolving landscape of peripheral artery disease, offering insights into effective and holistic management strategies.
动脉粥样硬化血管疾病的全球流行病学转变见证了其负担的快速重新分配,从高收入国家向低收入和中等收入国家转移。外周动脉疾病具有广泛的临床谱,从间歇性跛行到更复杂的临界肢体威胁性缺血、不愈合溃疡、坏疽以及急性肢体缺血,尽管其患病率很高,但常常面临诊断不足和治疗不足的挑战。患有多种合并症的外周动脉疾病患者的管理带来了巨大的挑战,仍然是一个紧迫的全球健康关注问题。在这篇综述中,我们旨在深入了解外周动脉疾病的病理生理学,并探讨涵盖药物治疗、生活方式、介入和手术方法的循证管理策略。通过解决这些挑战,本综述有助于更好地了解外周动脉疾病的不断变化的格局,提供对有效和整体管理策略的深入了解。