TY - CHAP M1 - Book, Section TI - Infrapopliteal Disease A1 - Pannu, Rajmony A2 - Baliga, R. R. A2 - Lilly, Scott M. A2 - Abraham, William T. Y1 - 2018 N1 - T2 - Color Atlas and Synopsis of Interventional Cardiology AB - Infrapopliteal (IP) peripheral arterial disease (PAD) often occurs as part of multilevel atherosclerotic disease and is more commonly seen in patients with long-standing diabetes mellitus, patients with chronic kidney disease, or the elderly.1 Presence of moderate stenosis with 1 or 2 critical lesions can disrupt pulsatile flow to the limb. Chronic stable limb ischemia is predominantly asymptomatic, with a minority (20%) of patients complaining of symptoms of claudication. Rest pain and/or tissue necrosis occurs (Figure 36-1) when the compensatory mechanisms that were developed in absence of straight line flow, such as ischemic preconditioning of the limb and development of the collaterals, are no longer capable to meeting the oxygen demands.2 The arterial tree below the knee has relatively smaller-caliber vessels that in this population are often calcified, and stenotic lesions are rather diffuse (Figure 36-2). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesscardiology.mhmedical.com/content.aspx?aid=1160208043 ER -