Peripheral Vascular Intervention

Abstract

Peripheral arterial disease refers to the development of atherosclerotic plaque leading to the narrowing of arteries outside the heart. Approximately 16% of adults aged over 55 years have peripheral arterial disease (PAD) in the USA and Western Europe. Approximately 50% of patients with PAD are asymptomatic with their disease detectable only by their ankle brachial index (ABI). In patients that are symptomatic, PAD can lead to lifestyle-limiting claudication, critical limb ischemia, and limb loss. It is estimated that approximately 1.3% of the population have critical limb ischemia which requires limb salvage therapy with endovascular or surgical interventions. Since PAD is a local manifestation of systemic atherosclerosis, patients are also at two to sixfold risk for other cardiovascular events including coronary artery disease and cerebrovascular disease. This combined with the high prevalence of chronic kidney disease in this population makes patients with PAD one of the most challenging populations to manage medically as well as with endovascular and surgical treatments.