DISEASE INFLUENCING FACTORS : DIET, LIFE STYLE, ENVIRONMENT, SMOAKING, ALCOHOL, DRUG ABUSE, LACK OF EXERCISE, HYPERHOMOCYTEINEMIA, FAMILY H/O HYPERFIBROGENEMIA, HYPERTENSION, AGE, DIABETES MELLITUS, HYPERLIPEDEMIA , ATHEROSCLEROSIS,
GENERAL MEASURES:
β’ Smoking cessation
β’ Foot and limb care
β’ Graduated exercise program
β’ Weight control
β’ Pain management
β’ Cholesterol management
β’ Appropriate treatment of coexisting disease, i.e., diabetes
β’ Infection control
β’ Lifestyle modifi cation
SURGICAL MEASURES:
β’ Indications for surgery are ischemic pain at rest, or changes likely to lead to amputation, or intolerable
symptoms
β’ The procedure depends upon site of lesion. Includes endarterectomy, bypass procedures, transluminal
angioplasty, and amputation.
β’ Patients with aorto-iliac disease tend to have good surgical results to a disabling disorder
β’ Surgery should not be performed for femoral popliteal disease unless symptoms are very severe or disabling
β’ Bypass surgery for vessels distal to popliteal artery has little success
β’ Patch grafting
β’ Atherectomy
β’ Laser angioplasty
β’ Stents (wire plastic mesh to stretch and mold to the arterial wall to prevent re-occlusion)
β’ Amputation with failure of arterial reconstructive surgery or with development of gangrene, persistent infection, or intractable pain
DRUG(S) OF CHOICE:
β’ Vasodilator drugs are ineffective
β’ Aspirin to decrease platelet aggregation
β’ Newer antiplatelet agents such as clopidogrel look promising
PATIENT MONITORING:
β’ For acute phase with surgery, closely follow all aspects of postoperative recovery
β’ For mild chronic cases, follow patient at regular intervals, frequency dependent upon severity of symptoms
β’ Management/modifi cation of risk factors
PREVENTION/AVOIDANCE:
β’ Periodic health maintenance measures
β’ Healthy lifestyle including appropriate diet and adequate exercise
β’ Avoidance of smoking
POSSIBLE COMPLICATIONS
β’ Necrosis
β’ Gangrene
β’ Limb amputation