دانلود کتاب بیماری شریان محیطی – استراتژی درمانی در حال تکامل

Peripheral arterial disease (PAD) is a universal problem affecting 10–15% of the general population and is particularly prevalent with age. PAD is a marker for higher cardiovascular events and mortality. A broader approach to treat these patients is of paramount importance to reduce the morbidity and mortality of patients with this disease. There has been a shift in the PAD treatment from a focus on revasculariza­tion to implementing aggressive preventative therapies and improving the quality of life of these patients. Pharmacologic and structured exercise interventions are now first steps to improve the symptoms of patients with claudication. Revascularization is typically reserved for claudicants that fail medical therapy, and for patients with advanced limb ischemia with rest pain or ulcerations. Chronic limb-threatening ischemia (CLTI) needs to be addressed aggressively with simultaneous preventa­tive, pharmacologic, and revascularization strategies to reduce its burden of amputa­tion and mortality. Smoking, diabetes, and chronic kidney disease are major risk factors that need to be addressed and controlled. Several pharmacologic interven­tions including antiplatelets, statins or PCSK-9 inhibitors, low dose rivaroxaban, SGLT2 inhibitors, and others are now available for the endovascular specialist to treat the PAD patient.