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Lower Extremity Peripheral Artery Disease 2024

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4 Overview Table 2. Definitions of PAD Key Terms Term Definition ALI Acute (≤2 wk) hypoperfusion of the limb that may be characterized by: pain, pallor, pulselessness, poikilothermia, paresthesias, and/or paralysis. ALI is further classified according to the Rutherford classification system (Table 4). Anatomic level Anatomic subsets to localize disease in the lower extremity. Patients with PAD can have multilevel arterial disease across multiple segments. • Aortoiliac—Includes infrarenal abdominal aorta, common iliac, and external and internal iliac arteries. • Femoropopliteal—Includes common femoral, profunda femoris, superficial femoral, and popliteal arteries. • Infrapopliteal—Includes tibial-peroneal trunk, anterior tibial artery, posterior tibial artery, peroneal artery, plantar pedal loop, and pedal vessels (common plantar, medial plantar, and lateral plantar arteries). Angiosome- based blood flow Uninterrupted arterial flow to the anatomic territory of a source artery in the skin and deep tissues. In the context of PAD, the angiosome refers to the skin region and underlying tissue, generally with a wound, supplied by a specific infrapopliteal artery. Claudication Fatigue, cramping, aching, pain, or other discomfort of vascular origin in the muscles of the lower extremities that is consistently induced by walking and consistently relieved by rest (usually within approximately 10 min). Claudication that limits functional status is known as functionally limiting claudication. Claudication is recognized as a manifestation of chronic symptomatic PAD (see Section 2.1, "Recognizing Clinical Subsets for PAD"). CLTI A condition characterized by chronic (>2 wk) ischemic rest pain, nonhealing wounds and ulcers, or gangrene attributable to objectively proven arterial occlusive disease. Current nomenclature has evolved from the previous commonly used term of CLI to reflect the chronic nature of this condition and its potentially limb-threatening nature with associated risk for amputation and to distinguish it from ALI. Endovascular revascularization Catheter-based revascularization procedures employing modalities such as percutaneous transluminal (balloon) angioplasty, drug- coated balloon angioplasty, stenting (bare metal, drug coated, or covered), and atherectomy. Note: The numbering of the following tables and figures may differ from that of the Clinical Practice Guideline. Colors in tables and figures correspond to Class of Recommendations and Level of Evidence tables on pages 54–55.

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