[Conservative treatment of peripheral arterial disease].

Patients with peripheral arterial disease (PAD) often have polyvascular atherosclerosis and are at increased risk of major adverse cardiovascular events (MACE), such as cardiovascular death, myocardial infarction or stroke, and major adverse limb events (MALE), such as amputation and acute limb ischemia. Therefore, the aim of conservative treatment is the reduction of MACE and MALE. In patients with intermittent claudication, the aim is also to extend walking distance. Management of risk factors includes smoking cessation, statin therapy, reduction of low-density lipoprotein cholesterol (target < 55 mg/dL and reduction to at least 50% of baseline value), normalization of blood glucose and treatment of arterial hypertension (target < 140/90 mm Hg). Moreover, antithrombotic treatment should include antiplatelet therapy (acety salicylic acid 100 mg or clopidogrel 75 mg). In patients at high thrombotic risk and low bleeding risk combination of acetlylic acid 100 mg and rivaroxaban 2 × 2.5 mg is indicated. In patients with intermittent claudication exercise therapy is highly recommended. Despite the high risk, in particular patients with PAD are often undertreated in clinical practice.