Percutaneous Therapies for Peripheral Artery Disease
Mehdi H Shishehbor1, Michael R Jaff2
1From Heart and Vascular Institute, Cleveland Clinic, OH (M.H.S.); and the Fireman Vascular Center, Massachusetts General Hospital, Boston (M.R.J.).
Circulation
|December 14, 2016
Summary
Percutaneous therapies for peripheral artery disease (PAD) are advancing with new devices and techniques. These endovascular interventions improve quality of life and reduce amputation rates for PAD patients.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Background:
- Guidelines-recommended therapies impact cardiovascular outcomes.
- Endovascular interventions improve quality of life and reduce amputation for peripheral artery disease (PAD).
- Advancements in devices and techniques are crucial for managing PAD.
Purpose of the Study:
- To review the evolution of percutaneous therapies for PAD.
- To discuss novel devices and techniques for treating PAD.
- To aid vascular specialists in choosing optimal management strategies for PAD patients.
Main Methods:
- Review of current literature on percutaneous therapies for PAD.
- Discussion of novel devices like drug-eluting stents and drug-coated balloons.
- Exploration of new adjunctive devices and imaging tools like intravascular ultrasound.
Main Results:
- Novel devices improve patency for moderate lesions and allow treatment of complex lesions.
- Intravascular ultrasound aids in understanding treatment mechanisms and optimizing device selection.
- Tibiopedal access and angiosome-directed revascularization improve outcomes for critical limb ischemia.
Conclusions:
- Percutaneous therapies for PAD continue to evolve with improved outcomes.
- Future treatment may involve segment-specific approaches considering plaque morphology and disease characteristics.
- Optimizing cost-effective, efficacious, and safe treatments remains paramount for individual PAD patients.
Keywords:
critical limb ischemiaendovascular therapylimb salvageperipheral artery diseasevascular diseasesMore Related Videos
10:50Osmotic Drug Delivery to Ischemic Hindlimbs and Perfusion of Vasculature with Microfil for Micro-Computed Tomography Imaging
Published on: June 29, 2013
12.8K
10:28Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
6.1K
Related Concept Videos
01:27Peripheral Artery Disease III: Interprofessional Care
472
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
472
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
569
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
569
01:26Peripheral Artery Disease IV: Nursing Management
522
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
522
01:23Peripheral Artery Disease V: Postoperative Nursing Management
494
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
494
01:30Peripheral Artery Disease I: Introduction
521
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
521
01:27Coronary Artery Disease V: Interprofessional Care
357
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
357