Health Sciences & Medicine
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Atherosclerosis leads all the causes of occlusive arterial disease in the periphery in patients over age of 40 years; although, the highest incidence is noted in the sixth and seventh decades of the lifespan. Similar to atherosclerosis of the coronary and cerebral arteries, individuals with diabetes mellitus, hypercholesterolemia, hypertension, or hyperhomocysteinemia and cigarette smoking have an increased prevalence of peripheral arterial disease.


According to statistics delineated in different articles, the primary sites of involvement are the abdominal aorta and iliac arteries comprising 30% of symptomatic patients; the femoral and popliteal arteries consisting of 80 to 90% of patients, and the more distal vessels, including the tibial and peroneal arteries making 40 to 50% of patients (McDermott, 2006, S2). Mechanically and topographically, atherosclerotic lesions occur preferentially at arterial branch points, which are sites of increased turbulence leading to altered shear stress, and hence injury to the tunica intima. Epidemiologic and demographic data suggest that the distal vasculature is most commonly involved in elderly individuals, mostly in patients with diabetes mellitus (Marso and Hiatt, 2006, 921-929).
The history and physical examination are usually sufficient to establish the diagnosis of peripheral arterial disease (PAD). An objective assessment of the severity of disease is obtained by noninvasive techniques. ...
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