Am Fam Physician. 2025;112(5):571-573
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• The ABI, or toe-brachial index when the ABI demonstrates noncompressible arteries, should be used for the diagnosis of PAD in patients with findings suggestive of or at high risk for PAD. [corrected]
• Structured exercised therapy is recommended at least three times per week for 12 weeks in patients with chronic symptomatic PAD and improves walking distance, functional status, and quality of life.
• Single antiplatelet therapy with clopidogrel is recommended for symptomatic PAD; low-dose rivaroxaban combined with low-dose aspirin benefits select patients at high risk.
• Cilostazol reduces claudication symptoms and may reduce restenosis after endovascular therapy.
From the AFP Editors
Peripheral artery disease (PAD) is a common cardiovascular disease that impacts walking, overall function, and quality of life. It also increases the risk of amputation, myocardial infarction, stroke, and death. The American College of Cardiology and American Heart Association (ACC/AHA) have released guidelines for the management of PAD.
CLINICAL SUBSETS
ACC/AHA defines four PAD subsets: asymptomatic, chronic symptomatic, chronic limb-threatening ischemia, and acute limb ischemia. Patients can move into and out of subsets due to deterioration from disease progression or improvement of symptoms with treatment.
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