Risk factors
- Modifiable factors
- Nicotine use
- Hypertension
- Diabetes
- Hyperlipidemia
- diet/sedentary lifestyle/obesity
- Inflammation (elevated C-reactive protein
- Homocysteinemia
- Nonmodifiable factors
- Increasing age
- Female gender
- Genetics
Clinical Manifestations
- Intermittent claudications (early sign) which eventually progresses to rest pain
- Atypical lower extremity pain
- Diminished pulses… where
- Bruit
- Nails are brittle, delayed capillary refill
- Skin discoloration: pallor with elevation and deep red when leg in dependent positon
(dependent rubor)
- Skin is thin, dry, shiny with hair loss
- Ulceration and gangrene with progressive PAD
PAD progression
- Lower extremity pain
- Claudication
- Atypical extremity pain
- Ischemic rest pain
- Severe diffuse pain
- Non Healing wound/ulcer
- Full-thickness skin necrosis
Peripheral Arterial Ulcers
- Characteristics
- Locations - toe joints, malleoli (bony prominence), anterior shin, base of heel,
pressure points, large and shallow
- Appearance - irregular margins, base dry and often pale or necrotic (brown/black
fibrous tissue)
- Sensation - pain, especially when supine, some pain relief when leg placed in
dependent position
- Pulses - absent
- Modifiable factors
- Nicotine use
- Hypertension
- Diabetes
- Hyperlipidemia
- diet/sedentary lifestyle/obesity
- Inflammation (elevated C-reactive protein
- Homocysteinemia
- Nonmodifiable factors
- Increasing age
- Female gender
- Genetics
Clinical Manifestations
- Intermittent claudications (early sign) which eventually progresses to rest pain
- Atypical lower extremity pain
- Diminished pulses… where
- Bruit
- Nails are brittle, delayed capillary refill
- Skin discoloration: pallor with elevation and deep red when leg in dependent positon
(dependent rubor)
- Skin is thin, dry, shiny with hair loss
- Ulceration and gangrene with progressive PAD
PAD progression
- Lower extremity pain
- Claudication
- Atypical extremity pain
- Ischemic rest pain
- Severe diffuse pain
- Non Healing wound/ulcer
- Full-thickness skin necrosis
Peripheral Arterial Ulcers
- Characteristics
- Locations - toe joints, malleoli (bony prominence), anterior shin, base of heel,
pressure points, large and shallow
- Appearance - irregular margins, base dry and often pale or necrotic (brown/black
fibrous tissue)
- Sensation - pain, especially when supine, some pain relief when leg placed in
dependent position
- Pulses - absent
