Peripheral Arterial Diseases

Peripheral vascular diseases are common, and are associated with major morbidity and mortality, and yet they continue to receive less intense clinical attention than coronary artery or myocardial disease. The term peripheral vascular disease has been used historically to denote the noncardiac arterial occlusive diseases. This traditional term is best applied to describe the global set of pathophysiologic syndromes that affect the arterial, venous, and lymphatic circulations. Precision in medicine is based on precision of terminology. The distinct and diverse vascular syndromes encompass many etiologies and natural histories, as well as differing diagnostic and treatment pathways. Thus, use of a more specific nomenclature is required. The arterial diseases include those disorders that cause either fixed obstruction or abnormal vascular reactivity of the arteries supplying a given tissue; the obstruction impairs blood delivery and can produce ischemia. Venous diseases occur in response to processes that impede normal venous function, including all noncardiac causes of venous hypertension. These disorders include venous valvular incompetence and venous hypertension, deep venous thrombosis, pulmonary embolism, postphlebitic syndrome, and varicose veins.