p.3 抽出テキスト

Table of contents

1. Preamble .............................................................................................................. 3547 2. Introduction ....................................................................................................... 3548 3. What is new ....................................................................................................... 3550 4. Epidemiology and risk factors ..................................................................... 3558 4.1. Epidemiology ............................................................................................ 3558 4.2. Risk factors ................................................................................................ 3559 5. Evaluation of peripheral arteries and aorta .......................................... 3560 5.1. Clinical history and examination, and laboratory assessment, in patients with peripheral arterial and aortic diseases .................. 3560 5.2. Functional and quality of life assessment in patients with peripheral arterial and aortic diseases ................................................... 3560 5.3. Vascular examination of peripheral arteries ............................... 3561 5.3.1. Duplex ultrasound ......................................................................... 3562 5.3.2. Digital subtraction angiography, computed tomography angiography, and magnetic resonance angiography ..................... 3562 5.4. Evaluation of the aorta ......................................................................... 3562 5.4.1. Aortic measurements ................................................................... 3562 5.4.2. Normal aortic values ..................................................................... 3565 5.4.3. Chest X-ray and electrocardiogram ....................................... 3565 5.4.4. Echocardiography ........................................................................... 3565 5.4.5. Duplex ultrasound imaging of the abdominal aorta ........ 3566 5.4.6. Cardiovascular computed tomography ................................ 3566 5.4.7. Cardiovascular magnetic resonance ....................................... 3566 5.4.8. Positron emission tomography ................................................. 3566 5.4.9. Intravascular ultrasound ............................................................... 3567 5.4.10. Digital subtraction aortography ............................................. 3567 6. Screening for carotid, peripheral arterial, and aortic diseases ..... 3567 6.1. Screening for carotid and peripheral arterial diseases ........... 3567 6.1.1. Lower-extremity peripheral arterial disease ....................... 3567 6.1.2. Carotid artery stenosis ................................................................ 3567 6.1.3. Multisite artery disease ................................................................. 3567 6.2. Screening for aortic diseases ............................................................. 3568 6.2.1. Screening for abdominal aortic aneurysm ........................... 3568 6.2.2. Screening for thoracic aortic aneurysm ................................ 3568 7. Optimal medical treatment ......................................................................... 3568 7.1. Lifestyle, exercise, patient education ............................................. 3568 7.1.1. Diet ....................................................................................................... 3568 7.1.2. Physical activity ................................................................................ 3569 7.1.3. Smoking ............................................................................................... 3570 7.1.4. Patient education ............................................................................ 3570 7.1.5. Risk scoring models in secondary prevention .................... 3570 7.2. Principles of pharmacological medical therapy .......................... 3571 7.2.1. Antithrombotic therapy ............................................................... 3571 7.2.2. Antihypertensive therapy ............................................................ 3571 7.2.2.1. Renovascular hypertension ................................................ 3571 7.2.3. Lipid-lowering therapy ................................................................. 3572 7.2.3.1. Statins .......................................................................................... 3572 7.2.3.2. Ezetimibe ................................................................................... 3572 7.2.3.3. Proprotein convertase subtilisin/kexin type 9 inhibitors .................................................................................................... 3572 7.2.3.4. Bempedoic acid ....................................................................... 3572 7.2.3.5. Hypertriglyceridaemia .......................................................... 3572 7.2.4. Diabetes and pre-diabetes conditions ................................... 3573 7.2.5. Other pharmacological therapy ............................................... 3574 8. Peripheral arterial disease ............................................................................ 3574 8.1. Lower-extremity peripheral arterial disease .............................. 3574 8.1.1. Peripheral arterial disease syndromes ................................... 3574 8.1.1.1. Clinical presentation and diagnosis ................................. 3574 8.1.1.1.1. Diagnostic tests .............................................................. 3575 8.1.1.1.2. Imaging methods ............................................................ 3576 8.1.1.2. Medical treatment .................................................................. 3578 8.1.1.2.1. Exercise therapy ............................................................ 3578 8.1.1.2.2. Pharmacological treatment ....................................... 3582 8.1.1.2.3. Aorto-iliac lesion revascularization ........................ 3583 8.1.1.2.4. Femoro-popliteal lesion revascularization .......... 3584 8.1.1.2.5. Below-the-knee artery revascularization ........... 3584 8.1.1.3. Follow-up ................................................................................... 3585 8.1.2. Chronic limb-threatening ischaemia ....................................... 3585 8.1.2.1. Clinical presentation and diagnosis ................................. 3585 8.1.2.1.1. Definition .......................................................................... 3585 8.1.2.1.2. Initial assessment and risk of amputation ........... 3585 8.1.2.1.3. Imaging ............................................................................... 3585 8.1.2.1.4. Mortality risk assessment ........................................... 3585 8.1.2.2. Medical treatment .................................................................. 3586 8.1.2.3. Interventional treatment ..................................................... 3586 8.1.2.3.1. Revascularization ............................................................ 3586 8.1.2.3.2. Spinal cord stimulation ................................................ 3587 8.1.2.3.3. Amputation ...................................................................... 3587 8.1.2.4. Follow-up ................................................................................... 3587 8.1.3. Acute limb ischaemia .................................................................... 3587 8.1.3.1. Clinical presentation and diagnosis ................................. 3587 8.1.3.1.1. Clinical examination ..................................................... 3588 8.1.3.1.2. Imaging and functional tests ...................................... 3588 8.1.3.2. Medical treatment .................................................................. 3588 8.1.3.3. Surgical and interventional treatment ........................... 3588 8.1.3.4. Follow-up ................................................................................... 3590 8.2. Extracranial carotid and vertebral artery disease ..................... 3590 8.2.1. Clinical presentation and diagnosis ......................................... 3590 8.2.1.1. Clinical presentation ............................................................. 3590 8.2.1.2. Diagnosis .................................................................................... 3590 8.2.2. Asymptomatic carotid artery stenosis .................................. 3591 8.2.2.1. Medical treatment .................................................................. 3591 8.2.2.1.1. Lipid-lowering therapy ................................................ 3591 8.2.2.1.2. Antihypertensive therapy ........................................... 3591 8.2.2.1.3. Glucose-lowering therapy ......................................... 3591 8.2.2.1.4. Antithrombotic therapy ............................................. 3591 8.2.2.2. Interventional treatment ..................................................... 3592 8.2.2.2.1. Open surgery vs. medical therapy ......................... 3592 8.2.2.2.2. Carotid revascularization: surgery vs. stenting . 3592 8.2.3. Symptomatic carotid artery stenosis ..................................... 3594 8.2.3.1. Medical treatment .................................................................. 3594 8.2.3.1.1. Lipid-lowering therapy ................................................ 3594 8.2.3.1.2. Antihypertensive therapy ........................................... 3594 8.2.3.1.3. Glucose-lowering therapy ......................................... 3594 8.2.3.1.4. Antithrombotic therapy ............................................. 3594 8.2.3.2. Interventional treatment ..................................................... 3595 8.2.3.2.1. Open surgery .................................................................. 3595 8.2.3.2.2. Endovascular therapy vs. open surgery ................ 3595 8.2.3.2.3. Vertebral arteries .......................................................... 3595 8.2.3.3. Follow-up ................................................................................... 3596 8.3. Other arterial locations ....................................................................... 3596 8.3.1. Subclavian artery disease ............................................................. 3596 8.3.1.1. Clinical presentation and diagnosis ................................. 3596 8.3.1.2. Treatment strategy (medical and interventional) ..... 3597 8.3.1.3. Follow-up ................................................................................... 3597 8.3.2. Renal artery disease ....................................................................... 3598 Downloaded from academic.oup.com/eurheartj/article/45/36/3538/7738955 by guest on 07 October 2026