Management of peripheral arterial occlusive disease

The proper use of medical therapeutic agents in the management of peripheral arterial occlusive disease must be based upon a thorough understanding of the factors controlling vasomotor tone and vasospasm, mechanisms regulating blood flow in skin and muscle, factors favoring nutritional and shunt flow, effects of the diversion of blood from one vascular bed to another, muscle contraction as a factor which may limit the blood flow to a part, epinephrine sensitivity after sympathectomy, and the effects of vasodilator drugs on the local and total circulations.THERE ARE SIX MAJOR CLASSES OF THERAPY FOR PERIPHERAL ARTERIOSCLEROSIS: General medical care, administration of vasodilator drugs and administration of anticoagulants, sympathectomy, direct vascular operation and amputation. In many cases the most successful treatment is a combination of medical and surgical therapy.