REVIEW  PERIPHERAL DISEASE Open access

International Angiology 2025 Apr 03

DOI: 10.23736/S0392-9590.25.05302-7

Copyright © 2025 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.

language: English

Smoking and lower extremity artery disease

Pier L. ANTIGNANI ¹ ✉, Pavel POREDOŠ ², Aleš BLINC ^{2, 3}, Matija CEVC ⁴, Agata STANEK ^{4, 5}, Arkadiusz JAWIEN ⁶, Armando MANSILHA ^{7, 8}

¹ Vascular Center, Nuova Villa Claudia, Rome, Italy; ² Department of Vascular Diseases, University Medical Center of Ljubljana, Ljubljana, Slovenia; ³ Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; ⁴ Department of Internal Medicine and Metabolic Diseases and Angiology, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; ⁵ Upper-Silesian Medical Center of the Medical University of Silesia, Katowice, Poland; ⁶ Department of Vascular Surgery and Angiology, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland; ⁷ Faculty of Medicine, University of Porto, Porto, Portugal; ⁸ Department of Angiology and Vascular Surgery, Hospital de S. Joao, Porto, Portugal

Cigarette smoking is a major preventable risk factor for lower extremity arterial disease (LEAD) and is strongly associated with a higher risk of disease progression, worse post-procedural outcomes, and increased healthcare utilization. Smoking provokes the development of atherosclerotic through different mechanisms. Endothelial cell dysfunction, oxidative stress, inflammation, and arterial stiffness are among the key factors related to the development of atherogenesis due to smoking. Smoking cessation among patients with LEAD and the use of smoking cessation methods, including pharmacological treatment, are mandatory. Given that smoking cessation interventions remain underutilized. Therefore, in this narrative review we highlight the importance of incorporating smoking cessation treatments as part of the medical management of LEAD. Regulatory approaches to reduce tobacco use and support smoking cessation have the potential to reduce the burden of LEAD.

KEY WORDS: Smoking; Peripheral arterial disease; Atherosclerosis