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Concluding remarks

To date, PAD patients suffer from several 

debated and unresolved concerns, such as the 

high risk of acute adverse cardiac events, modi-

fied or worsened quality of life induced by inter-

mittent claudication or by progressive pain in the 

lower limbs. Several medical therapies (i.e. drugs 

to lower serum cholesterol, inhibitors of platelet 

aggregation, anticoagulants) have been suggested 

to treat PAD, but these have not provided any 

clarity in achieving long-term results on clinical 

outcomes of PAD patients, whereas supervised 

exercise programs may be considered as very 

effective in treating walking performance of 

PAD patients, improving quality of life also. The 

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Therapeutic Advances in Chronic Disease 11

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pathophysiology of PAD is complex, including 

lowered hematic load, reduced tissue and cell 

perfusion, and respiratory capability. Both dis-

tributive arterial circulation (macrocirculation) 

and nutritional arterial circulation (microcircula-

tion) are progressively involved and severely dys-

functional. The screening and monitoring of 

several oxidative and inflammatory biomarkers 

and continuously supervised exercise as thera-

peutic strategies have proved effective in amelio-

rating the clinic parameters as well as pain-free 

walking distance.

118–120

 It is mandatory now to 

highlight more pathophysiological pathways aim-

ing to discover new medical drugs to achieve cru-

cial objectives for PAD patients.

Funding

The author(s) received no financial support for 

the research, authorship, and/or publication of this 

article.