Peripheral Artery Disease

Peripheral arterial occlusive disease (pAVD) – colloquially called shop window disease – (synonyms: Angina abdominalis; Arterial circulatory disorder of the leg; Arterial occlusive disease; Claudication intermittens; Circulatory disease; Intermittent claudication; Intermittent claudication; PAVD [Peripheral arterial occlusive disease]; Peripheral arterial occlusive disease; Occlusive disease; pAVK; pVK; Peripheral occlusive disease (pVK); Engl. PAD, peripheral arterial diseases; ICD-10 I73.9: Peripheral vascular disease, unspecified) is a progressive stenosis (narrowing) or occlusion (closure) of the arteries supplying the arms/ (more frequently) legs, usually due to atherosclerosis (arteriosclerosis, hardening of the arteries). This leads to a disturbance of the arterial blood flow in the affected extremities.

Atherosclerosis-related peripheral arterial occlusive disease results in gradual or complete occlusion (“occlusion”) to circulatory disturbances of the distal aorta and the iliac and leg arteries.

Lower extremity occlusive disease is referred to as LEAD (lower extremities arterial disease) in current guidelines.

Pathognomonic (characteristic of a disease) for occlusive disease of the lower extremities is intermittent claudication.

Peripheral arterial occlusive disease is considered a marker disease for the overall condition of the arterial vascular system.

Sex ratio: males to females is 4: 1.

Frequency peak: the disease occurs predominantly after the age of 60.

The prevalence (disease incidence) for symptomatic peripheral arterial occlusive disease is 3-10% (overall prevalence), 5% (> 60 years) and 15-20% (> 70 years) in Germany.In younger age groups, intermittent claudication is more common in men, but in older age groups there are hardly any gender differences.

Course and prognosis: Peripheral arterial occlusive disease (pAVK) is asymptomatic (without symptoms) in two-thirds of cases. The prognosis depends on the severity of the disease and the concomitant presence of other vascular risk factors such as diabetes mellitus or tobacco use. Smoking is the most important risk factor for pAVK. If smoking is not abstained from, the prognosis is poor. PAD is a risk factor for myocardial infarction (heart attack) as well as apoplexy (stroke). Physical activity, a balanced diet and, if necessary, weight reduction additionally improve the prognosis.

Note: The presence of pAVD increases the risk of cardiovascular events such as myocardial infarction (heart attack) or ischemic apoplexy (stroke)and at the same time worsens the prognosis of a patient with coronary artery disease (CAD).

Comorbidities (concomitant diseases)-coincidence (simultaneous occurrence of multiple diseases) of pAVD and coronary artery disease (CAD; coronary artery disease; 60-70% of cases) and heart failure (heart weakness) is common and worsens prognosis.