Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Glossary
- 1 The structure and production of blood platelets
- 2 Platelet immunology: structure, functions, and polymorphisms of membrane glycoproteins
- 3 Mechanisms of platelet activation
- 4 Platelet priming
- 5 Platelets and coagulation
- 6 Vessel wall-derived substances affecting platelets
- 7 Platelet–leukocyte–endothelium cross talk
- 8 Laboratory investigation of platelets
- 9 Clinical approach to the bleeding patient
- 10 Thrombocytopenia
- 11 Reactive and clonal thrombocytosis
- 12 Congenital disorders of platelet function
- 13 Acquired disorders of platelet function
- 14 Platelet transfusion therapy
- 15 Clinical approach to the patient with thrombosis
- 16 Pathophysiology of arterial thrombosis
- 17 Platelets and atherosclerosis
- 18 Platelets in other thrombotic conditions
- 19 Platelets in respiratory disorders and inflammatory conditions
- 20 Platelet pharmacology
- 21 Antiplatelet therapy versus other antithrombotic strategies
- 22 Laboratory monitoring of antiplatelet therapy
- 23 Antiplatelet therapies in cardiology
- 24 Antithrombotic therapy in cerebrovascular disease
- 25 Antiplatelet treatment in peripheral arterial disease
- 26 Antiplatelet treatment of venous thromboembolism
- Index
25 - Antiplatelet treatment in peripheral arterial disease
Published online by Cambridge University Press: 15 October 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Glossary
- 1 The structure and production of blood platelets
- 2 Platelet immunology: structure, functions, and polymorphisms of membrane glycoproteins
- 3 Mechanisms of platelet activation
- 4 Platelet priming
- 5 Platelets and coagulation
- 6 Vessel wall-derived substances affecting platelets
- 7 Platelet–leukocyte–endothelium cross talk
- 8 Laboratory investigation of platelets
- 9 Clinical approach to the bleeding patient
- 10 Thrombocytopenia
- 11 Reactive and clonal thrombocytosis
- 12 Congenital disorders of platelet function
- 13 Acquired disorders of platelet function
- 14 Platelet transfusion therapy
- 15 Clinical approach to the patient with thrombosis
- 16 Pathophysiology of arterial thrombosis
- 17 Platelets and atherosclerosis
- 18 Platelets in other thrombotic conditions
- 19 Platelets in respiratory disorders and inflammatory conditions
- 20 Platelet pharmacology
- 21 Antiplatelet therapy versus other antithrombotic strategies
- 22 Laboratory monitoring of antiplatelet therapy
- 23 Antiplatelet therapies in cardiology
- 24 Antithrombotic therapy in cerebrovascular disease
- 25 Antiplatelet treatment in peripheral arterial disease
- 26 Antiplatelet treatment of venous thromboembolism
- Index
Summary
INTRODUCTION
Progressive atherosclerosis complicated by thromboembolic events is by far the most common cause of peripheral arterial disease (PAD). The atherosclerotic process is a generalized disorder that almost invariably affects many vascular beds; therefore, any patient who presents with symptoms or signs suggestive of atherosclerotic disease in one vascular bed is likely to have other territories involved as well (Fig. 25.1). The common risk factors for atherosclerosis also apply to PAD, but the order of importance varies: smoking and diabetes correlate most strongly with disease of the leg arteries and predict its progression. The disease in the leg arteries remains clinically silent as long as no hemodynamically significant obstructive lesions develop. With the aid of simple noninvasive tests in middle-aged adults, subclinical disease is detected three to four times more often than is symptomatic disease (Fig. 25.2). Intermittent claudication, or leg pain on exercise that is relieved by rest, develops when the distal perfusion pressure decreases secondary to the high resistance in the proximal diseased arteries and the collateral vessels. Progression of the disease, to the extent that the blood flow is unable to meet the metabolic and nutritional demands of resting tissues, is clinically manifested by rest pain and skin lesions on the feet.
- Type
- Chapter
- Information
- Platelets in Hematologic and Cardiovascular DisordersA Clinical Handbook, pp. 458 - 470Publisher: Cambridge University PressPrint publication year: 2007