Peripheral Artery Disease (PAD)

Clinical features (NEJM 2016;374:861)

  • Prev. ↑ w/ age: <1% if <40 y, ~15% if ≥70 y; risk factors incl. smoking, DM, HTN, chol
  • Claudication (ache/cramp, often in calves) precip by walking and relieved by stopping (vs. spinal stenosis, qv); Leriche synd = claudic., ↓ or ∅ fem pulses, & erectile dysfxn
  • Critical limb ischemia (CLI): rest pain (↑ w/ elevation b/c ↓ perfusion), ulcer (typically at pressure foci, often dry; in contrast, venous ulcers are more often at medial malleolus, wet, and with hemosiderin deposition) or gangrene, s chronicity vs. acute limb ischemia; see below)