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• W2000409167 abstract "Lower extremity peripheral arterial disease (PAD) affects more than 10 million individuals in the United States, including an estimated 4.3% of adults older than 40 and 14.5% older than 70 [1,2]. Clinically, patients with PAD present in one of three ways—asymptomatic chronic subclinical ischemia, intermittent claudication, or critical limb ischemia. Critical limb ischemia presents as either rest pain or tissue loss. Treatment practices for each presentation have been established since the 1950s. When considering lower extremity PAD, any patient older than 40 years who is found to have an ankle-brachial index (ABI) of less than 0.9 has significant PAD, even in the absence of symptoms [3]. Interestingly, more than 50% of patients with an abnormal ABI fail to show typical symptoms of claudication or CLI, a condition referred to as asymptomatic chronic subclinical ischemia. There is little debate that initiation of cardiovascular risk factor modification and surveillance is the most appropriate treatment for these asymptomatic individuals. Conversely, there is general consensus that patients with critical limb ischemia should be offered surgical revascularization, believing that the severity of the vascular disease will result in major limb amputation in most cases if left untreated. The treatment of vasculogenic claudication, however, has been controversial since its first description. Conventional wisdom, founded on evidence from the 1960s and 1970s, has recommended nonoperative management for the vast majority of patients with intermittent claudication. This recommendation was based on the benign natural history of untreated claudication and the substantial risk associated with operative intervention. However, in recent years, revascularization has become more commonly used for patients with claudication. Three major factors have been influential. First is the acceptance of endovascular intervention by the vascular surgical community, a treatment modality largely dismissed as effective until the late" @default.
• W2000409167 created "2016-06-24" @default.
• W2000409167 creator A5051068027 @default.
• W2000409167 date "2009-09-01" @default.
• W2000409167 modified "2023-09-25" @default.
• W2000409167 title "Is Intermittent Vasculogenic Claudication Still a Nonsurgical Disease?" @default.
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• W2000409167 doi "https://doi.org/10.1016/j.yasu.2009.02.002" @default.
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