Smoking and occlusive peripheral arterial disease. Clinical review

Cigarette smoking is a strong but avoidable risk factor for development of cardiovascular disease and its acute complications. Intermittent claudication is most strikingly associated with smoking. The link between smoking and occlusive peripheral arterial disease is dose-dependent and can be broken by cessation of smoking. The risk of chronic as well as acute limb ischemia is then decreased in conservatively treated patients and also in those with reconstructive arterial surgery. Heavy smoking seems to abolish the positive effect of adjuvant antiplatelet medication. Cessation of smoking is a cornerstone in the management of occlusive peripheral arterial disease at any stage.