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Peripheral artery disease (PAD), also known as peripheral vascular disease (PVD), peripheral artery occlusive disease, and peripheral obliterative arteriopathy, is a narrowing of the arteries other than those that supply the heart or the brain. When narrowing occurs in the heart it is called coronary artery disease while in the brain it is called cerebrovascular disease. Peripheral artery disease most commonly affects the legs, but other arteries may also be involved.〔 The classic symptom is leg pain when walking which resolves with rest.〔 Other symptoms including skin ulcers, bluish skin, cold skin, or poor nail and hair growth may occur in the affected leg. Complications may include an infection or tissue death which may require amputation; coronary artery disease, or stroke.Up to 50% of cases of PAD are without symptoms. The main risk factor is cigarette smoking.〔 Other risk factors include diabetes, high blood pressure, and high blood cholesterol.〔 The underlying mechanism is usually atherosclerosis. Other causes include artery spasm.〔 PAD is typically diagnosed by finding an ankle-brachial index (ABI) less than 0.90, which is the systolic blood pressure at the ankle divided by the systolic blood pressure of the arm. Duplex ultrasonography and angiography may also be used.〔(【引用サイトリンク】url=http://www.nhlbi.nih.gov/health/health-topics/topics/pad/diagnosis )〕 Angiography is more accurate and allows for treatment at the same time; however, it is associated with greater risks.〔 It is unclear if screening for disease is useful as it has not been properly studied. In those with PAD stopping smoking and supervised exercise therapy improves outcomes.〔 Medications, including statins, ACE inhibitors, and cilostazol also may help. Aspirin does not appear to help those with mild disease but is usually recommended in those with more significant disease. Anticoagulants such as warfarin are not typically of benefit. Procedures used to treat the disease include bypass grafting, angioplasty, and atherectomy. In 2010 about 202 million people had PAD worldwide.〔 In the developed world it affects about 5.3% of 45 to 50 years olds and 18.6% of 85- to 90-year-olds.〔 In the developing world it affects 4.6% of people between the ages of 45 to 50 and 15% of people between the ages of 85 to 90.〔 In the developed world PAD is equally common among men and women while in the developing world women are more commonly affected. In 2013 PAD resulted in about 41,000 deaths up from 16,000 deaths in 1990. ==Signs and symptoms== Up to 50% of people with PAD may have no symptoms.〔 Symptoms of PAD in the legs and feet are generally divided into 2 categories: #Intermittent claudication—pain in muscles when walking or using the affected muscles that is relieved by resting those muscles. This is due to the unmet oxygen demand in muscles with use in the setting of inadequate blood flow. #Critical limb ischemia, consisting of: : *Rest pain, a pain in the soles of the feet, particularly when the feet are elevated, such as when in bed. : *Tissue loss, consisting of arterial insufficiency ulcers, which are sores or wounds that heal slowly or not at all, and gangrene. Medical signs of PAD in the legs, due to inadequate perfusion, include: * Noticeable change in color – blueness, or in temperature (coolness) when compared to the other limb. * Buerger's test can check for pallor on elevation of limb and redness (rubor) on a change to a sitting position, in an assessment of arterial sufficiency. * Diminished hair and nail growth on affected limb and digits PAD in other parts of the body depends on the organ affected. Renal artery disease can cause renovascular hypertension. Carotid artery disease can cause strokes and transient ischemic attacks. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Peripheral artery disease」の詳細全文を読む スポンサード リンク
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