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Medical treatment of peripheral artery occlusive disease (PAOD)
1Department of Cardiovascular Diseases Ghent University Hospital, Ghent, Belgium.
Insights
Peripheral artery occlusive disease (PAOD) signifies systemic atherosclerosis, not just limb ischemia. Managing risk factors and lifestyle changes are crucial for improving outcomes in PAOD patients.
Area of Science:
- Vascular Medicine
- Cardiology
- Neurology
Background:
- Peripheral artery occlusive disease (PAOD) is often viewed as a localized limb circulation issue.
- However, PAOD is a critical manifestation of systemic atherosclerosis, impacting other vascular beds.
- This systemic nature significantly influences patient mortality and morbidity.
Purpose of the Study:
- To reframe the understanding of PAOD among physicians.
- To emphasize PAOD as a marker for coronary and cerebral atherosclerosis.
- To highlight the importance of risk factor management in PAOD patients.
Main Methods:
- This is a review article, synthesizing existing medical knowledge.
- Focus is placed on the systemic implications of PAOD.
- Evidence regarding non-pharmacological and pharmacological treatments is discussed.
Main Results:
- PAOD patients frequently have concurrent atherosclerotic narrowing in coronary and cerebral arteries.
- Mortality and morbidity in PAOD are primarily driven by cardiovascular and cerebrovascular events.
- Risk factor control is paramount for improving patient prognosis.
Conclusions:
- PAOD serves as a significant indicator of widespread atherosclerosis.
- Effective PAOD management requires addressing systemic vascular health.
- Non-pharmacological interventions like exercise and smoking cessation are foundational, supplemented by pharmacotherapy for symptom relief.
Abstract:
The goal of this review is to focus attention of the physicians to the point that peripheral artery occlusive disease (PAOD) is not only a local problem impairing walking distance, but also a manifestation of atherosclerosis. As a consequence, one should realise that in PAOD patients, atherosclerotic narrowing is likely to be present in other territories such as the coronary and cerebral arteries; mortality and morbidity in PAOD will largely depend on impairment of the circulation in these areas more than on the local ischaemia in the limbs. Also, control of risk factors will be a major issue. The most important steps in the local medical treatment of PAOD are training and nicotine stop. All efforts should be given to help patients in their compliance to these non-pharmacological means. Vasoactive drugs have been shown to cause significantly positive effects on walking distance and for naftidrofuryl on quality of life; such effects should be seen as an addition to training and nicotine stop. The approach to PAOD has come in a completely new light in medicine since it is has been recognised as a major marker of coronary or cerebral atherosclerosis.