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外周动脉闭塞__培训课件.ppt 19页

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* PAD is highly associated with critical coronary and carotid artery disease that predispose these patients to a marked increase risk of myocardial infarction, ischemic stroke, and vascular death. Primary Goal Aggressive management of cardiovascular risk factors to prevent the progression of leg arterial disease and also to reduce the risk of ischemic events. ? Antiplatelet therapy, angiotensin-converting enzyme (ACE) inhibitor drugs, Statin Secondary Goal Severity of limb symptoms should be assessed ? Structured exercise program, Pletaal * PAD is a major manifestation of systemic atherothrombosis that affects a large segment of the adult population. The major treatment goals for this population are to address the marked increase risk in cardiovascular events and then secondarily to treat the disability and reduced exercise tolerance. Once patients have had a complete assessment and management of their risk factor, the second major of consideration is to address their limb symptoms. An important observation is that treatments that reduce cardiovascular risks generally do not improve their claudication symptoms. This claudication must be treated on its own merits. * Treatment of ASO according to Fontaine’s Classification: Several treatment options are currently available. These are the adjuvant therapy, Intravascular treatment and surgical bypass. Pharmacotherapy is usually recommended for patients under Level I, II and early level III The main stream of treatment for Fontaine’s Level IV is intravascular surgery. However, medication is needed after the intervention Many patients belong to level III, exercise and medication like Cilostazol could significantly relief claudication If symptoms worsens, then bypass surgery should be considered 田中靖久?学術部情報室PUB4402H01-49-032 * 亚洲的DM合并PAD情况:亚洲多国多中心的调查研究表明,50岁以上的DM患者的PAD患病率为17.7%(1172/6625)。 心血管健康研究(CHS)表明:DM使发生PAD的危险性增加4倍; 估计8%的DM患者在初诊DM时伴发PAD;10年后有15%的DM患者并发PAD;20年后有45%的DM患者并发PAD。 与非DM患者


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