This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Beckman, J. A. Search for Related Content PubMed PubMed Citation Articles by Beckman, J. A. Pubmed/NCBI databases Medline Plus Health Information Peripheral Arterial Disease Related Collections Peripheral vascular disease

(Circulation. 2007;115:550-552.)
© 2007 American Heart Association, Inc.

Editorial

Peripheral Endovascular Revascularization

Some Proof in the Pudding?

Joshua A. Beckman, MD, MS

From the Cardiovascular Division, Brigham and Women’s Hospital, Boston, Mass.

Correspondence to Joshua A. Beckman, MD, MS, Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115.

Key Words: Editorials • angioplasty • claudication • peripheral vascular diseases • quality of life • stents

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The diagnosis of peripheral arterial disease (PAD) provides an opportunity for significant medical intervention. All patients with PAD are at high risk of cardiovascular events, with mortality ranging from 15% to 50% in 5 years, depending on the severity of presenting symptoms.¹ Beyond this atherosclerotic risk, 50% of patients have leg pains and limitations in their ability to walk.

Article p 569

There are 2 major symptomatic manifestations of PAD: intermittent claudication and critical limb ischemia. Derived from the Latin word claudicatio, signifying a limp, intermittent claudication is an exertion-mediated leg muscle discomfort caused by arterial blood flow that is inadequate to meet the demands of exercising skeletal muscle. Patients may get relief from pain with exercise cessation, which restores the blood supply-demand equilibrium as the skeletal muscle oxygen requirements abate. Claudication is the most common symptom in PAD and the most common reason for which patients with PAD seek medical attention. The rarer and more serious complication of PAD is critical limb ischemia, which causes pain in the foot, a nonhealing ulceration, or frank gangrene, each signifying inadequate arterial blood supply to meet basal metabolic requirements. Without revascularization, patients with critical limb ischemia have a high risk of amputation. In contrast to the severe consequences of critical limb ischemia, the leg prognosis in intermittent claudication is benign. Nondiabetic patients with intermittent claudication have a <1% per year rate of developing critical limb ischemia.² However, the reduction in function remains stable for years, leaving patients with a chronic severe . . . [Full Text of this Article]