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Fundamental concepts and basic science 

Fundamental concepts and basic science
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date: 18 October 2019

The vast majority of patients with peripheral arterial disease suffer from atherosclerosis. Disease pathophysiology involves dyslipidaemia, vessel wall inflammation, vessel wall tissue degradation, and repair. Clinical manifestations are usually caused by rupture of the atherosclerotic plaque, thrombosis and subsequent organ ischaemia. Disease progression is mainly prevented by risk factor interventions (cessation of smoking, physical activity, monitoring of diabetes, and use of cardiovascular secondary preventive medication). The disease has a regional distribution in the vascular system and haemodynamic forces contribute to the formation and progression of the disease. Carotid atherosclerosis contributes to ischaemic stroke when lesions become unstable, rupture, and embolize to intracranial vessels. Although care for patients with peripheral atherosclerosis has improved, a detailed understanding of processes that lead to plaque instability is lacking and no diagnostic tools are available. Thus, further research is needed to develop diagnostic modalities aimed at improving patient selection for intervention.

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