Abstract

Peripheral arterial disease (PAD) is most often caused by atherosclerosis in the lower extremities, which can leads to a spectrum of life-altering symptomatology, including claudication, ischemic rest pain, or gangrene and eventually to amputation of the limb in some patients due to reduce blood flow. The clinical manifestation of PAD occurs along a spectrum with some patients being asymptomatic, while others describe disabling intermittent claudication (IC). An ABI less than 0.9 to confirm the diagnosis. Peripheral artery disease (PAD), is a direct macrovascular disorder of diabetes mellitus (DM). PAD raises the risk of DM, while diabete is a major risk factor for PAD. Factors Risk factors for PAD are the same as those for coronary artery disease and include: smoking, age, hypertension, obesity, diabetes mellitus, dyslipidemia, family history PAD. The prevalence of peripheral artery disease (PAD) continues to increase worldwide. It is important to identify patients with PAD because of the increased risk of myocardial infarction, stroke, and cardiovascular death and impaired quality of life because of a profound limitation in exercise performance and the potential to develop critical limb ischemia in diabetic patients. For patients with claudication, risk of major limb amputation is <1% per year, but the 5-year major adverse cardiovascular event risk including death approached 30%. The International Working Group on the Diabetic Foot (IWGDF) and ADA has published evidence-based guidelines on the prevention with management of PAD and diabetic foot disease, and to lower the cardiovascular risk. Clinical practice guidelines in the management of PAD in diabetic patients should be medical therapy, including smoking cessation, an exercise walking program, hypertension and blood glucose control, daily antiplatelet and statin therapy, as well as a trial of cilostazol. When revascularization is indicated, an “endovascular first” approach. The indications and strategic choices for endovascular revascularization will vary depending on the clinical severity of the PAD