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Chapter 148 Peripheral Artery Disease 2167
FUTURE DIRECTIONS PROGNOSIS AND OUTCOMES IN
PERIPHERAL ARTERY DISEASE
A better understanding of the factors that contribute to intermittent
claudication and CLI is needed to craft innovative and durable thera- Cacoub PP, Abola MT, Baumgartner I, et al: Cardiovascular risk factor
peutic interventions for management of the limb complications of control and outcomes in peripheral artery disease patients in the Reduc-
PAD. In addition, greater knowledge is needed about the unique tion of Atherothrombosis for Continued Health (REACH) registry.
contributors to atherogenesis and thrombosis in the lower extremities Atherosclerosis 204:e86, 2009.
compared with other arterial beds. Further understanding of down- Fowkes FG, Murray GD, Butcher I, et al: Ankle brachial index combined
stream effects of compromised blood flow, such as changes in skeletal with Framingham risk score to predict cardiovascular events and mortal-
muscle energetics and impaired neural function, will inform the ity: a meta-analysis. JAMA 300:197, 2008.
design and development of novel pharmacotherapies for individuals Kumbhani DJ, Steg PG, Cannon CP, et al: Statin therapy and long-term
with PAD. Finally, more comparative efficacy studies are needed to adverse limb outcomes in patients with peripheral artery disease: insights
clarify ongoing debates with respect to the relative benefits of exercise from the REACH registry. Eur Heart J 35(41):2864–2872, 2014.
training versus invasive therapies; endovascular versus surgical revas-
cularization; and the impact of cell-based therapies in the treatment
of PAD. Greater knowledge dissemination regarding PAD diagnosis THERAPY FOR PATIENTS WITH
and risks associated with PAD remain key to early detection and
implementation of risk factor modification therapies to improve the PERIPHERAL ARTERY DISEASE
care of this high-risk population.
Belch J, Hiatt WR, Baumgartner I, et al: Effect of fibroblast growth factor
Nv1FGF on amputation and death: a randomised placebo-controlled
SUGGESTED READINGS trial of gene therapy in critical limb ischaemia. Lancet 377:1929, 2011.
Berger JS, Krantz MJ, Kittelson JM, et al: Aspirin for the prevention of
COMPREHENSIVE GUIDELINES FOR THE cardiovascular events in patients with peripheral artery disease: a meta-
analysis of randomized trials. JAMA 301:1909, 2009.
MANAGEMENT OF PATIENTS WITH ATHEROSCLEROTIC Bhatt DL, Flather MD, Hacke W, et al: Patients with prior myocardial infarc-
VASCULAR DISEASE, INCLUDING EPIDEMIOLOGY, tion, stroke, or symptomatic peripheral arterial disease in the Charisma
PATHOPHYSIOLOGY, AND MANAGEMENT OF trial. J Am Coll Cardiol 49:1982, 2007.
PERIPHERAL ARTERY DISEASE Bonaca MP, Bhatt DL, Storey RF, et al: Ticagrelor for prevention of ischemic
events after myocardial infarction in patients with peripheral artery
disease. J Am Coll Cardiol 67:2719, 2016.
Gerhard-Herman MD, Gornik HL, Barrett C, et al: 2016 AHA/ACC guide- Cooke JP, Losordo DW: Modulating the vascular response to limb ischemia.
line on the management of patients with lower extremity peripheral artery Circ Res 116:1561, 2015.
disease: executive summary. J Am Coll Cardiol 69:1465–1508, 2017. Fakhry F, Spronk S, van der Laan L, et al: Endovascular revascularization
Hirsch AT, Haskal ZJ, Hertzer NR, et al: ACC/AHA 2005 Practice guidelines and supervised exercise for peripheral artery disease and intermittent
for the management of patients with peripheral arterial disease (lower claudication: a randomized clinical trial. JAMA 314:1936, 2015.
Extremity, renal, mesenteric, and abdominal aortic): a collaborative report Fowkes FG, Price JF, Stewart MC, et al: Aspirin for prevention of cardio-
from the American Association for Vascular Surgery/Society for Vascular vascular events in a general population screened for a low ankle brachial
Surgery, Society for Cardiovascular Angiography and Interventions, index: a randomized controlled trial. JAMA 303:841, 2010.
Society for Vascular Medicine and Biology, Society of Interventional Hiatt WR, Fowkes FGR, Heizer G, et al: Ticagrelor versus clopidogrel in
Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing symptomatic peripheral artery disease. N Engl J Med 376:32, 2017.
Committee to Develop Guidelines for the Management of Patients with Murphy TP, Cutlip DE, Regensteiner JG, et al: Supervised exercise versus
Peripheral Arterial Disease): endorsed by the American Association of primary stenting for claudication resulting from aortoiliac peripheral artery
Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and disease: six-month outcomes from the claudication: Exercise Versus Endo-
Blood Institute; Society for Vascular Nursing; Transatlantic Inter-Society luminal Revascularization (CLEVER) study. Circulation 125:130, 2011.
Consensus; and Vascular Disease Foundation. Circulation 113:e463, Pande RL, Hiatt WR, Zhang P, et al: A pooled analysis of the durability and
2006. predictors of treatment response of cilostazol in patients with intermittent
Kullo IJ, Rooke TW: Peripheral artery disease. N Engl J Med 374:861, 2016. claudication. Vasc Med 15:181, 2010.
Norgren L, Hiatt WR, Dormandy JA, et al: Inter-society consensus for the Heart Study Collaboration Group: Randomized trial of the effects of
management of peripheral arterial disease (TASC II). J Vasc Surg 45:S5, cholesterol-lowering with simvastatin on peripheral vascular and other
2007. major vascular outcomes in 20,536 people with peripheral arterial disease
Rooke TW, Hirsch AT, Misra S, et al: 2011 ACCF/AHA Focused update and other high-risk conditions. J Vasc Surg 45:645, 2007.
of the guideline for the management of patients with peripheral artery Stewart KJ, Hiatt WR, Regensteiner JG, et al: Exercise training for claudica-
disease (updating the 2005 guideline): a report of the American College tion. N Engl J Med 347:1941, 2002.
of Cardiology Foundation/American Heart Association Task Force on Tepe G, Zeller T, Albrecht T, et al: Local delivery of paclitaxel to
Practice Guidelines. Circulation 124:2020, 2011. inhibit restenosis during angioplasty of the leg. N Engl J Med 358:689,
2008.
Yusuf S, Sleight P, Pogue J, et al: Effects of an angiotensin-converting-enzyme
PREVALENCE, INCIDENCE, AND RISK FACTORS inhibitor, ramipril, on cardiovascular events in high-risk patients. The
FOR PERIPHERAL ARTERY DISEASE Heart Outcomes Prevention Evaluation study investigators. N Engl J Med
342:145, 2000.
Criqui M, Aboyans V: Epidemiology of peripheral artery disease. Circ Res Bonaca MP, Scirica BM, Creager MA, et al: Vorapaxar in patients with
116:1509, 2015. peripheral artery disease: results from TRA2P-TIMI 50. Circulation
Fowkes FG, Rudan D, Rudan I, et al: Comparison of global estimates of 127(14):1522–1529, 2013.
prevalence and risk factors for peripheral artery disease in 2000 and 2010:
a systematic review and analysis. Lancet 382(9901):1329–1340, 2013.
Pande RL, Perlstein TS, Beckman JA, et al: Secondary prevention and REFERENCES
mortality in peripheral artery disease: National Health and Nutrition
Examination Study, 1999 to 2004. Circulation 124:17, 2011. For the complete list of references, log on to www.expertconsult.com.

