13 Women with PAD may also demonstrate a faster functional decline and greater mobility loss than men, as recently shown by McDermott et al.14 Figure 1 The right foot of a 56-year-old woman with aggressive metastatic non-small cell lung cancer who developed acute onset of progressive right forefoot critical ischemia. (A) dorsal view showing discoloration

at base of first toe and tips of toes with colored … The diagnostic work-up for PAD includes physiologic studies, duplex ultrasound, Inhibitors,research,lifescience,medical and computed tomography (CT) or magnetic resonance (MR) angiography. The image quality of all three modalities has improved remarkably over the years, permitting an accurate assessment of the patient’s arterial anatomy and disease lesions (Figure 2). Selective digital subtraction angiography is now rarely indicated for diagnostic confirmation but is used instead for therapeutic endovascular interventions. Inhibitors,research,lifescience,medical There are no gender-specific differences in the diagnostic evaluation for PAD. After a complete assessment, it is helpful to determine the extent of disease according to the TransAtlantic InterSociety Consensus (TASC) anatomical classification to plan therapeutic intervention and for reporting.15 Figure Inhibitors,research,lifescience,medical 2 Three-dimensional volume rendering of reconstructed CT angiogram of a 57-year-old woman with ischemic rest pain

in the right leg, demonstrating chronic occlusion of the right common and external iliac and common femoral arteries. The patient had previously Inhibitors,research,lifescience,medical … Medical Therapy for PAD in Women Modification of risk factors and medical therapy remain the first line of treatment for all patients with PAD.5, 16, 17 In brief, a smoking cessation program should be instituted in all active smokers. Inhibitors,research,lifescience,medical Continued tobacco smoking has been associated with a higher risk of amputation in patients with intermittent claudication, lower patency in leg bypass grafts, and increased risk of myocardial infarction and death.18-20 Patients with intermittent claudication should be encouraged to continue to exercise. Furthermore,

participation in a supervised Obeticholic Acid in vitro exercise program has been shown to produce superior symptomatic 4-Aminobutyrate aminotransferase improvement in these patients compared to unsupervised exercise.21, 22 Medical therapy aims at keeping the HgbA1c level to less than 7% in diabetic patients, reducing serum low-density lipoprotein cholesterol level to less than 70 mg/dL in patients with hypercholesterolemia, and lowering the blood pressure to less than 130/80 mm Hg in hypertensive patients.23-26 In addition, antiplatelet, statin, angiotensin-converting enzyme inhibitor, and β-blockade agents have all been shown to be beneficial in PAD patients.26-32 We therefore recommend prescribing these agents to all PAD patients unless otherwise contraindicated.