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5.6. Other Medical Therapies for Cardiovascular Risk
Reduction in PAD
COR LOE
Recommendations
1 C-LD
1. Patients with PAD should receive an annual influenza
vaccination.
1 C-EO
2. Patients with PAD should receive the severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) vaccination
sequence, including the booster(s).
2a B-R
3. In patients at high cardiovascular risk, a diet emphasizing
intake of vegetables, fruits, legumes, nuts, whole grains, and
fish can be beneficial for reducing the risk of developing PAD
and the risk of MACE.
3: No
Benefit
B-R
4. In patients with PAD, B-complex vitamin supplementation
to lower homocysteine levels is not beneficial for prevention
of MACE.
3: No
Benefit
B-R
5. In patients with PAD, chelation therapy (eg, EDTA) is not
beneficial for prevention of MACE.
3: No
Benefit
B-R
6. In patients with PAD, vitamin D supplementation is not
beneficial for prevention of MACE.
5.7. Medications for Leg Symptoms in Chronic
Symptomatic PAD
COR LOE
Recommendations
Cilostazol
1 A
1. In patients with claudication, cilostazol is recommended to
improve leg symptoms and increase walking distance.
2b B-R
2. In patients with PAD, cilostazol may be useful to reduce
restenosis after endovascular therapy for femoropopliteal
disease.
3: Harm C-LD
3. In patients with PAD and congestive heart failure of any
severity, cilostazol should not be administered.
Pentoxifylline
3: No
Benefit
B-R
4. In patients with chronic symptomatic PAD, pentoxifylline is
not recommended for treatment of claudication.
Chelation erapy
3: No
Benefit
B-R
5. In patients with chronic symptomatic PAD, chelation therapy
is not recommended for treatment of claudication.
