Peripheral arterial disease arises when there is significant narrowing of arteries distal to the arch of the aorta. Narrowing can arise from atheroma, arteritis, local thrombus formation, or embolisation from the heart, or more central arteries. This review includes treatment options for people with symptoms of reduced blood flow to the leg that are likely to arise from atheroma. These symptoms range from calf pain on exercise to rest pain, skin ulceration, or symptoms of ischaemic necrosis (gangrene) in people with critical limb ischaemia.
Peripheral arterial disease is more common in people aged over 50 years than in younger people, and is more common in men than in women. The prevalence of peripheral arterial disease of the legs (assessed by non-invasive tests) is about 14% to 17% in men and 11% to 21% in women over 55 years of age. The overall annual incidence of intermittent claudication 4.1 to 12.9 per 1000 men and 3.3 to 8.2 per 1000 women.
Approximately 8 million people are affected by PAD each year in the U.S. Approximately 1M patients present with significant clots.