Abstract
Peripheral artery occlusive disease is characterised by stenosis or occlusion of one or more peripheral arteries, mainly caused by atherosclerosis. The disease can be asymptomatic initially but is typically manifested with intermittent claudications and, in the most advanced stage, with rest pain or even with leg defects.
The ischemia may be acute, leg threatening, however, the most frequent course is chronic, slowly progressing. Nevertheless, the prognosis of patients is poor; their cardiovascular morbidity and mortality is high because of the systemic nature of atherosclerosis.
Primary diagnostics includes physical examination and, particularly, ankle-brachial index, obtained by dopplerometric or oscillometric measurement. CT angiography or digital substraction angiography are used for more precise imaging of arterial stenosis or occlusion.
The therapy of acute leg ischemia is targeted at restoration of blood flow and salvage of the limb and life of the patient. In chronic stages, the therapy aims at lowering cardiovascular risk, relief from symptoms and preventing disease progression.
Conservative therapy includes risk factor intervention, antiplatelets, exercise therapy and pharmacotherapy of claudications. The patients with more advanced disease should undergo revascularization therapy (surgery and/or radiointervention).