4.4 Review

Peripheral arterial disease: a literature review

Journal

BRITISH MEDICAL BULLETIN
Volume 104, Issue 1, Pages 21-39

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/bmb/lds027

Keywords

peripheral arterial disease; atherosclerosis; revascularization; bypass surgery; atherectomy

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Peripheral arterial disease (PAD) is a common vascular condition that affects both quality of life and life expectancy with an increased risk of cardiovascular events. A literature search was carried out of Pub-Med, MEDLINE, the Cochrane Library and Google Scholar from the establishment of these databases up to February 2012. The search was performed by using the keywords operipheral arterial disease' and one of the following words: omanagement', oinvestigations', orisk factors', oepidemiology', orevascularization', ocryoplasty', oatherectomy' and ogene therapy'. Studies were limited to those published in English language. Aggressive risk factors modification is needed to reduce cardiovascular-related mortality in PAD patients. Choice of endovascular or surgical intervention remains controversial in an ever-evolving field. There is a rapid expansion of endovascular technologies aiming to improve the effectiveness of this modality. The advances in the fields of gene therapy and therapeutic angiogenesis mean these are potential future treatments. Tissue engineering is a developing area and aims to produce grafts with similar patency and infection profiles to those of autologous material. Further elucidation of the pathophysiology of atherosclerosis is required to provide new targets for pharmacotherapy.

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