Dtsch Med Wochenschr 2015; 140(24): 1798-1802
DOI: 10.1055/s-0041-107064
Klinischer Fortschritt
© Georg Thieme Verlag KG Stuttgart · New York

Periphere arterielle Verschlusskrankheit: Epidemiologie, Komorbidität und Prognose

Update PAVK: Epidemiology, comorbidity and prognosis of peripheral arterial obstructive disease
Holger Lawall
1   Max-Grundig Klinik, Bühlerhöhe, 77815 Bühl
2   Praxis für Herzkreislauferkrankungen, Ettlingen
Curt Diehm
1   Max-Grundig Klinik, Bühlerhöhe, 77815 Bühl
2   Praxis für Herzkreislauferkrankungen, Ettlingen
Ulrich Hoffmann
3   Sektion Angiologie, Gefäßzentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München
Holger Reinecke
4   Abteilung für Angiologie, Department für Kardiologie und Angiologie, Universitätsklinikum, Münster
› Author Affiliations
Further Information

Publication History

Publication Date:
01 December 2015 (online)


Die Häufigkeit der PAVK nimmt weltweit zu und auch in der Bundesrepublik steigt die Zahl der stationär behandelten Patienten kontinuierlich an. Die Knöchel- und Zehendruckmessungen mit Bestimmung des ABI bzw. TBI sind zuverlässige Methoden zur Diagnostik. Klinisch relevante Begleiterkrankungen sind die KHK, Herz- und chronische Niereninsuffizienz, und der Diabetes mellitus. Patienten mit asymptomatischer und symptomatischer PAVK haben eine deutlich erhöhte Morbidität und Mortalität.


The number of patients suffering from PAD is increasing worlwide and the rate of hospitalized patients in Germany is continously increasing. The diagnosis can be made reliably by ankle- and toe-pressure measurements with calculating the ABI and TBI. Clinical relevant comorbidities are CAD, heart insuffiency , chronic renal failure and diabetes. The prognosis of asymptomatic and symptomatic patients is characterized by an increased cardiovascular morbidity and mortality.

  • Literatur

  • 1 Xu D, Zou L, Xing Y et al. Diagnostic value of ankle-brachial index in peripheral arterial disease: a meta-analysis. Can J Cardiol 2013; 29: 492-498
  • 2 Alahdab F, Wang AT, Elraiyah TA et al. A systematic review for the screening for peripheral arterial disease in asymptomatic patients. J Vasc Surg 2015; 61: 42S-53S
  • 3 Huyn S, Forbang NI, Allison MA et al. Ankle-brachial index, toe-brachial index, and cardiovascular mortality in persons with and without diabetes mellitus. J Vasc Surg 2014; 60: 390-395
  • 4 Fowkes FG, Rudan D, Rudan I et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 2013; 382: 1329-1340
  • 5 Malyar N, Furstenberg T, Wellmann J et al. Recent trends in morbidity and in-hospital outcomes of in-patients with peripheral arterial disease: a nationwide population-based analysis. Eur Heart J 2013; 34: 2706-2714
  • 6 Chou SW, Kim BG, Kim DK et al. Prediction of coronary artery disease in patinets with lower extremity peripheral artery disease. Int Heart J 2015; 56: 209-212
  • 7 Bell AD, Roussin D, Popvici-Toma D et al. The value of routine screening for peripheral arterial disease in stable outpatients with history of corornary artery and cerebrovascular disease. Int J Clin Pract 2013; 67: 996-1004
  • 8 Subherwal S, Patel MR, Kober L et al. Peripheral arterial disease is a coronary heart disease risk equivalent among both men and women : results from a nationwide study. Eur J Prev Cardiol 2015; 22: 317-325
  • 9 Inglis SC, Bebchuk J, Al-Suhaim SA et al. Peripheral arterial disease and outcomes after myocardial infarction: an individual-patient meta-analysis of 28 771 patients in CAPRICORN, EPHESUS, OPTIMAAL and VALIANT. Int J Cardiol 2013; 168: 1094-1101
  • 10 Meltzer AJ, Shrikhande G, Gallagher KA et al. Heart failure is associated with reduced patency after endovascular intervention for symptomatic peripheral arterial disease. J Vasc Surg 2012; 55: 353-362
  • 11 Jones WS, Clare R, Ellis SJ et al. Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from HF-ACTION). Am J Card 2011; 108: 380-384
  • 12 Ryden L, Grant PJ, Anker SD et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD – summary. Diab Vasc Dis Res 2014; 11: 133-173
  • 13 Zhang Y, Hu G, Yuan Z, Chen L. Glycosylated hemoglobin in relationship to cardiovascular outcomes and death in patients with type 2 diabetes: a systematic review and meta-analysis. PloS one 2012; 7: e42551
  • 14 Singh S, Armstrong EJ, Sherif W et al. Association of elevated fasting glucose with lower patency and increased major adverse limb events among patients with diabetes undergoing infrapopliteal ballon angioplasty. Vasc Med 2014; 19: 307-314
  • 15 Charles M, Ejskjaer N, Witte DR et al. Prevalence of neuropathy and peripheral arterial disease and the impact of treatment in people with screen-detected type 2 diabetes: the ADDITION-Denmark study. Diabetes Care 2011; 34: 2244-2249
  • 16 Ray KS, Seshasai SR, Wijesuriya S et al. Effect of intensive control on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet 2009; 373: 1765-1772
  • 17 Garamilla B, Hirsch AT. Peripheral artery disease and chronic kidney disease: clinical synergy to improve outcomes. Adv Chronic Kidney Dis 2014; 21: 460-471
  • 18 Garimella PS, Hart PD, O’Hare A et al. Peripheral artery disease and CKD: a focus on peripheral artery disease as a critical component of CKD care. Am J Kidney Dis 2012; 60: 641-654
  • 19 Engelhardt M, Boos J, Bruijnen H et al. Critical limb ischaemia: initial treatment and predictors of amputation-free survival. Eur J Vasc Endovasc Surg 2012; 43: 55-61
  • 20 Diehm C, Allenberg JR, Haberl R et al. High all-cause mortality in patients with peripheral arterial disease in primary care: five-year results of the getABI Study. Circulation 2007; 116: II 841-b (Suppl.)
  • 21 Golomb BA, Dang TT, Criqui MH. Peripheral arterial disease: morbidity and mortality. Circulation 2006; 114: 688-699
  • 22 Cambou JP, Aboyans V, Constans J et al. Characteristics and outcome of patients hospitalised for lower extremity peripheral artery disease in France: the COPART Registry. Eur J Vasc Endovasc Surg 2010; 39: 577-585
  • 23 Reinecke H, Unrath M, Freisinger E et al. Peripheral arterial disease and critical limb ischaemia: still poor outcomes and lack of guideline adherence. Eur Heart J 2015; 36: 932-938