[Peripheral arterial disease]

The peripheral arterial disease (PAD) accounts for very significant medical issue in the world. Various clinical disorders due to coronary, cerebrovascular, abdominal and obliterative arteriosclerosis of extremities can be classified as the most important medical challenges. This review summarises the etiopathogenesis of this systemic problem including the function of endothelium as well as the anatomic, physiologic relevance, and major risk factors of atherosclerosis (diabetes mellitus, hypertension, obesity, smoking etc.). The first step is the dysfunction of endothelial monolayer, later on the plaques caused by humoral and cellular reactions can produce abnormal blood flow. The atherosclerosis in relation to plaque rupture with intraarterial thrombosis constitutes acute and chronic circulation disturbances and tissue damage. Diagnostic procedures are also presented regarding not only the symptomatic, but focusing on the early, asymptomatic phase of the disease, as well. By giving full details of the acute and chronic treatment the author emphasizes its basic concepts. He also points out the importance of evidence based medicine.