Optimal management of infrainguinal arterial occlusive disease

David J. Pennywell, Tze Woei Tan, Wayne W. Zhang

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Peripheral arterial occlusive disease is becoming a major health problem in Western societies as the population continues to age. In addition to risk of limb loss, the complexity of the disease is magnified by its intimate association with medical comorbidity, especially cardiovascular and cerebrovascular disease. Risk factor modification and antiplatelet therapy are essential to improve long-term survival. Surgical intervention is indicated for intermittent claudication when a patient's quality of life remains unacceptable after a trial of conservative therapy. Open reconstruction and endovascular revascularization are cornerstone for limb salvage in patients with critical limb ischemia. Recent advances in catheter-based technology have made endovascular intervention the preferred treatment approach for infrainguinal disease in many cases. Nevertheless, lower extremity bypass remains an important treatment strategy, especially for reasonable risk patients with a suitable bypass conduit. In this review, we present a summary of current knowledge about peripheral arterial disease followed by a review of current, evidence-based medical and surgical therapy for infrainguinal arterial occlusive disease.

Original languageEnglish (US)
Pages (from-to)599-608
Number of pages10
JournalVascular Health and Risk Management
StatePublished - 2014
Externally publishedYes


  • claudication
  • critical limb ischemia
  • endovascular infrainguinal intervention
  • infrainguinal bypass
  • peripheral arterial disease
  • peripheral vascular disease

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hematology
  • Public Health, Environmental and Occupational Health
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)


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