Prognosis of Patients with Peripheral Arterial Disease

Abstract

Peripheral arterial disease (PAD) is becoming an increasingly important health issue in Western Society. PAD is affecting approximately 8 to 12 million adults in the USA and more than 30 million adults worldwide1. These symptomatic patients represent the ‘top of the ice-berg’, creating a major health burden. For every patient with symptomatic PAD, 3 to 4 patients have PAD without clinical complaints like claudication intermittens2. Especially in patients with PAD undergoing major vascular surgery, a high incidence of coronary artery disease (CAD) has been observed, which also may be asymptomatic or symptomatic. In patients with PAD requiring aortic or lower limb revascularization procedure surgery, the prevalence of CAD is about 50 to 70%3-5. Hence, it is not surprising that these patients are at increased risk for perioperatieve and long-term cardiac complications. Cardiac death accounts for approximately 40% of all 30-day mortality after surgery and for 65% of all deaths during longterm follow-up6. Importantly, the prognosis of patients with PAD is related to the presence and extent of CAD, as well as the regulation of cardiovascular risk factors