Surgical intervention

Cilostazol Therapeutic angiogenesis

Fig. 46.1 Management of peripheral arterial disease.

severity of claudication and mortality. Hyperglycemia, meanwhile, precedes the development of PAD and lower extremity amputation in patients with diabetes. A 1% increase in glycosylated haemoglobin (HbAlc) was associated with a 35-42% increased risk for ABPI <0.9 or obstructed crural arteries. In the UKPDS, patients who were allocated to tight gly-caemic control showed a trend towards a reduction in deaths from PAD and fewer amputations (relative risk 0.61; P = 0.099).3

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