Peripheral arterial disease is a lack of perfusion in the extremities resulting from atherosclerosis . It is characterized by intermittent claudication and an ankle brachial index of 0.9 or less . Clinical presentation subsets include asymptomatic, chronic symptomatic, chronic limb-threatening ischemia, and acute limb ischemia .

Vascular Medicine

Peripheral artery disease

Peripheral artery disease: claudication, limb outcomes, antithrombotic therapy and revascularization.

Also called PAD, peripheral arterial disease, claudication, limb ischemia

Sources: 12 new papers · 5 key papers · updated Oct 20, 2026

Overview

Unverified · drafted by AI from the sources cited below

Definition

Peripheral arterial disease is a lack of perfusion in the extremities resulting from atherosclerosis.1

Diagnosis and risk stratification

Diagnosis typically involves the ankle-brachial index, though limitations of single measurements have prompted prospective cohort studies to evaluate variability across time points such as 8:00, 12:00, and 18:00.1 Risk stratification involves assessing multiple factors, including lipoprotein(a) levels, with one large study observing 2,450 incident cases among 108,146 individuals.2 Significant clinical disparities exist, as Black people have an approximately 2-fold higher prevalence of the disease and experience greater mobility loss and higher amputation rates.3

Treatment

Medical therapy can include anticoagulation and antiplatelet strategies, where the combination of 2.5 mg rivaroxaban twice daily and 100 mg aspirin once daily reduces major adverse cardiovascular events compared with 100 mg aspirin once daily.1 Revascularization is central to managing severe cases like chronic limb-threatening ischemia, prompting a Delphi consensus among 51 European and 17 USA-based experts to address conflicting results regarding best endovascular treatment versus surgical revascularization.2 Additionally, lipoprotein apheresis serves as an adjunctive treatment for severe cases.3

How this page is built

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Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.

Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.

The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition