ABSTRACT

Peripheral arterial disease (PAD) is defined as atherosclerosis of the lower extremities and is a marker for atherosclerotic disease in all other blood vessels. The most common symptom of PAD is intermittent claudication, defined as pain, cramping, or aching in the calves, thighs, or buttocks that occurs with walking and is relieved by rest. More extreme presentations of PAD include rest pain, tissue loss, or gangrene. PAD is also a major risk factor for lower extremity amputation, particularly in patients with diabetes. Moreover, even for the asymptomatic patient, PAD is a marker for systemic vascular disease involving coronary, cerebral, and renal vessels, leading to an elevated risk of events such as myocardial infarction, stroke, and death (1). Diabetes and smoking are the strongest risk factors for PAD. Other well-known risk factors are advanced age, hypertension, and hyperlipidemia (2).