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Chapter 15 - Peripheral Artery Disease
from Section III - Care of the Elderly by Organ System
- By Rachelle Hamadi, Casey N. Rust
Edited by Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Samuel C. Durso, The Johns Hopkins University, Maryland, Christine Arenson, Thomas Jefferson University, Philadelphia, Rebecca Elon, The Johns Hopkins University School of Medicine, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel
Book:

Reichel's Care of the Elderly

Published online:

30 June 2022

Print publication:

21 July 2022, pp 180-188
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Summary

This chapter gives an overview of the pathophysiology, prevalence, risk factors, and symptoms of peripheral artery disease (PAD). The subsequent screening, diagnosis, and management of PAD are further elucidated. The chapter specifically emphasizes the prevalence of PAD in the elderly and the impact of disease. PAD results from the obstruction of peripheral arteries, leading to a reduction in blood flow to the extremities. PAD may be asymptomatic or lead to a variety of symptoms including claudication, chronic skin discoloration, hair loss, non-healing ulcers, and infections. PAD prevalence increases with increasing age, thus elderly patients should be routinely evaluated for symptoms of extremity pain and non-healing wounds. An ankle-brachial index (ABI) of less than 0.9 is diagnostic for PAD. Treatments for PAD may include the management of medical comorbidities, exercise, smoking cessation, medications such as antiplatelets and vasodilators, and surgical interventions. Early intervention can prevent limb ischemia and ultimately limb loss.