Study note

Pathogenesis of peripheral arterial disease and its relationship to diabetes

THE CONTEXT

In developed countries, almost all peripheral arterial disease is caused by atherosclerosis, with risk factors shared with coronary artery disease.

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Plaque rupture causes the most serious manifestations of peripheral arterial disease and may occur in a previously asymptomatic plaque.

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Clinical manifestations depend on anatomical site, collateral supply, speed of onset and mechanism of injury.

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Approximately 5%–10% of patients with peripheral arterial disease have diabetes; this rises to 30%–40% among those with severe limb ischaemia.

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The mechanism in diabetes is atheroma affecting medium to large-sized arteries rather than obstructive microangiopathy.

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Diabetes is not a contraindication to lower limb revascularisation.

NEETx

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