Escalating treatment for peripheral arterial disease
THE CONTEXT
The passage describes treatment for persistent disability in peripheral arterial disease and the usual intervention for subclavian artery disease.
Persistent symptoms and intervention
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Cilostazol is a peripheral vasodilator that can improve walking distance and should be considered when the response to best medical therapy is inadequate.
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Angioplasty, stenting, endarterectomy or bypass is usually considered only after at least 6 months of medical therapy intended to improve symptoms.
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Intervention is then reserved for patients who remain severely disabled or whose disability threatens their livelihood.
Subclavian artery disease
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Angioplasty and stenting are usually used because carotid–subclavian bypass surgery can be technically difficult.