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[Recommended interventions for the treatment of peripheral artery disease : Keep the patients moving].
Internist (Berl) 2019; 60(12):1235-1239I

Abstract

BACKGROUND

Peripheral artery disease (PAD) is often diagnosed in an advanced stage. Accordingly, revascularization is also performed late.

OBJECTIVES

In this paper, the authors describe the progression to critical limb ischemia and cardiovascular risk. Revascularization for secondary prevention is explained. Revascularization strategies according to lesion location and complexity of the stenosis or occlusion are discussed.

MATERIALS AND METHODS

The current guidelines and randomized controlled studies and meta-analyses are analyzed.

RESULTS

PAD is associated with a considerable level of suffering and a high cardiovascular risk. Up to 20% of patients with claudicants will progress to critical limb ischemia. Progression and risk of mortality increase during the course of the disease. Improvement of walking ability by revascularization is a major goal of secondary prevention. In the femoropopliteal segment, drug-coated balloon (DCB) angioplasty and bare-metal stent (BMS) implantation are the methods of choice. In long lesions, spot-stenting should be preferred. For treatment of in-stent restenosis, DCB have proven their effectiveness. In severely calcified or dissected lesions, BMS are well suited. Infrapopliteal lesions should be revascularized to provide in-line flow to the foot through the target arterial path. According to current evidence, DCB or drug-eluting stents are more effective than plain old balloon angioplasty or BMS.

Authors+Show Affiliations

Zentrum für Gefäβmedizin, Abteilung Angiologie, Asklepios Klinikum Harburg, Eiβendorfer Pferdeweg 52, 21075, Hamburg, Deutschland. h.krankenberg@asklepios.com.

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

31667527

Citation

Krankenberg, H. "[Recommended Interventions for the Treatment of Peripheral Artery Disease : Keep the Patients Moving]." Der Internist, vol. 60, no. 12, 2019, pp. 1235-1239.
Krankenberg H. [Recommended interventions for the treatment of peripheral artery disease : Keep the patients moving]. Internist (Berl). 2019;60(12):1235-1239.
Krankenberg, H. (2019). [Recommended interventions for the treatment of peripheral artery disease : Keep the patients moving]. Der Internist, 60(12), pp. 1235-1239. doi:10.1007/s00108-019-00695-x.
Krankenberg H. [Recommended Interventions for the Treatment of Peripheral Artery Disease : Keep the Patients Moving]. Internist (Berl). 2019;60(12):1235-1239. PubMed PMID: 31667527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Recommended interventions for the treatment of peripheral artery disease : Keep the patients moving]. A1 - Krankenberg,H, PY - 2019/11/2/pubmed PY - 2019/11/2/medline PY - 2019/11/1/entrez KW - Angioplasty KW - Drug-eluting stents KW - Intermittent claudication KW - Ischemia, critical KW - Secondary prevention SP - 1235 EP - 1239 JF - Der Internist JO - Internist (Berl) VL - 60 IS - 12 N2 - BACKGROUND: Peripheral artery disease (PAD) is often diagnosed in an advanced stage. Accordingly, revascularization is also performed late. OBJECTIVES: In this paper, the authors describe the progression to critical limb ischemia and cardiovascular risk. Revascularization for secondary prevention is explained. Revascularization strategies according to lesion location and complexity of the stenosis or occlusion are discussed. MATERIALS AND METHODS: The current guidelines and randomized controlled studies and meta-analyses are analyzed. RESULTS: PAD is associated with a considerable level of suffering and a high cardiovascular risk. Up to 20% of patients with claudicants will progress to critical limb ischemia. Progression and risk of mortality increase during the course of the disease. Improvement of walking ability by revascularization is a major goal of secondary prevention. In the femoropopliteal segment, drug-coated balloon (DCB) angioplasty and bare-metal stent (BMS) implantation are the methods of choice. In long lesions, spot-stenting should be preferred. For treatment of in-stent restenosis, DCB have proven their effectiveness. In severely calcified or dissected lesions, BMS are well suited. Infrapopliteal lesions should be revascularized to provide in-line flow to the foot through the target arterial path. According to current evidence, DCB or drug-eluting stents are more effective than plain old balloon angioplasty or BMS. SN - 1432-1289 UR - https://www.unboundmedicine.com/medline/citation/31667527/[Recommended_interventions_for_the_treatment_of_peripheral_artery_disease_:_Keep_the_patients_moving] L2 - https://dx.doi.org/10.1007/s00108-019-00695-x DB - PRIME DP - Unbound Medicine ER -
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