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GUIDELINES  PERIPHERAL ARTERIAL DISEASE Editor’s choice • Freefree

International Angiology 2021 February;40(1):29-41

DOI: 10.23736/S0392-9590.20.04518-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

How to manage patients with polyvascular atherosclerotic disease. Position paper of the International Union of Angiology

Pavel POREDOS 1 , Ales BLINC 1, 2, Salvatore NOVO 3, Pier L. ANTIGNANI 4

1 Department of Vascular Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; 2 Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; 3 Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy; 4 Nuova Villa Claudia Vascular Center, Rome, Italy



Atherosclerosis is a systemic disease affecting multiple arterial territories. Patients with clinical atherosclerotic disease in one vascular bed are likely to have asymptomatic or symptomatic atherosclerotic lesions in other vascular beds. Specifically, peripheral arterial disease (PAD) often coexists with coronary and carotid disease. With progression of atherosclerotic disease in one vascular bed, the risk of clinical manifestations in other territories increases and the incidence of adverse cardiovascular events increases substantially with the number of affected vascular beds. Classical risk factors are associated with the development of polyvascular atherosclerotic disease (PVD) in different territories; however, to a different extent. Risk modification represents basic treatment of patients with PVD. All modifiable risk factors should be aggressively controlled by lifestyle modification and medication. Particular attention should be directed to patients with PAD who are often undertreated in spite of the proven benefits of guideline-based approach. There is currently no proof that identification of asymptomatic atherosclerosis and PVD improves clinical outcomes in patients who are already in prevention programs. Revascularization should be performed only in symptomatic vascular beds, using the least aggressive method according to consensual decision of a multidisciplinary vascular team.


KEY WORDS: Atherosclerosis; Diagnostic techniques and procedures; Risk factors

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