Medical Therapy of Occlusive Arterial Disease

¹ Section of Medicine, Mayo Clinic and Mayo Foundation.

1. Occlusion of the abdominal aorta, segmental occlusion of the iliac and femoral arteries, thromboangiitis obliterans and arteriosclerosis obliterans constitute the major diseases affecting the peripheral arteries. The first two conditions are now treated surgically.

2. The general principles of medical treatment that apply to occlusive arterial diseases are to arrest the progress of the disease, to dilate the uninvolved vessels, to increase circulation mechanically, to relieve pain, to instruct in prevention of injury to ischemic tissue and to treat ulceration and gangrene.

3. Abstinence from tobacco is imperative. Anticoagulants are of value in acute arterial occlusion but usually are not of practical value for prevention of thrombosis in chronic occlusive arterial disease.

4. Pain in occlusive arterial disease may be due to intermittent claudication, ischemic neuritis, or ulceration and gangrene.

5. Early diagnosis is important. Appropriate surgical procedures can be performed if the disease is segmental. If the disease is diffuse, use of adequate active and prophylactic treatment may do much to prevent pain, disability, gangrene and economic loss.