mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/2072-3180-2022-43-51mossj-615Research ArticleСтатьиХронические облитерирующие заболевания артерий нижних конечностей. Современное амбулаторное лечениеChronic obliterating diseases of the arteries of the lower extremities. Modern outpatient treatmentГригорьеваА. И.GrigorievaA. I.

Григорьева Анна Ивановна – к.м.н., врач-хирург

127273, Москва, ул. Декабристов, 24

Grigorieva Anna Ivanovna – Candidate of Medical Sciences, surgeon

24 Dekabristov str., Moscow, 127273

grigorevaanna@internet.ruГосударственное бюджетное учреждение здравоохранения «Городская поликлиника №107 Департамента здравоохранения города Москвы»РоссияState Budgetary Healthcare Institution ”City Polyclinic No 107 of Moscow City Health Department”Russian Federation20220501202305Специальный выпуск4351Copyright © Григорьева А.И., 20232023Григорьева А.И.Grigorieva A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/615

Хронические облитерирующие заболевания артерий нижних конечностей (ХОЗАНК) составляют до 20 % от всего объема сердечно-сосудистых патологии. Человеческие и экономические издержки этого заболевания очень высоки.  

Основной принцип лечения ХОЗАНК - непрерывность и использование всех доступных фармакологических и нефармакологических способов лечения, которые направлены на снижение риска развития любого осложнения со стороны сердечно-сосудистой системы, прогрессирования ишемии нижних конечностей, а также на устранение ее клинических проявлений – перемежающейся хромоты. Благодаря современным и доступным методам диагностики, таким как ультразвуковое дуплексное сканирование сосудов (УЗДС), появляется все больше возможностей раннего выявления бессимптомного течения облитерирующего атеросклероза нижних конечностей. Для пациентов с ХОЗАНК рекомендуется долгосрочная антиагрегантная терапия, отказ от курения, липидоснижающая терапия, а также терапия диабета и артериальной гипертензии. Статья показывает, что в мировой доказательной базе появляется все больше данных об эффективном применение статинов, цилостозала и комбинированной антитромбоцитарной и антитромботической терапии после хирургического лечения. Внедрение этих методов лечения остается сложной задачей из-за дороговизны и бремени полипрагмазии и требует дальнейших исследований.

Chronic arterial occlusive disease of the lower extremities (CAODLE) account for up to 20% of the total volume of cardiovascular pathology. The human and economic costs of this disease are very high.  

The main principle of the treatment of Chronic arterial occlusive disease of the lower extremities is the continuity and use of all available pharmacological and non-pharmacological methods of treatment, which are aimed at reducing the risk of developing any complication from the cardiovascular system, progression of lower limb ischemia, as well as eliminating its clinical manifestations – intermittent lameness. Thanks to modern and affordable diagnostic methods, such as ultrasound duplex vascular scanning (USDS), there are more and more opportunities for early detection of asymptomatic course of obliterating atherosclerosis of the lower extremities. For patients with CAODLE, long-term antiplatelet therapy, smoking cessation, lipid-lowering therapy, as well as diabetes and hypertension therapy are recommended. The article shows that in the world evidence base there is more and more data on the effective use of statins, cilostosal and combined antiplatelet and antithrombotic therapy after surgical treatment. The introduction of these treatments remains a challenge due to the high cost and burden of polypragmasia and requires further research.

бессимптомное течение заболеванияцилостазолпентоксифиллинсердечно-сосудистые заболеваниялечениеasymptomatic course of the diseasecilostazolpentoxifyllinecardiovascular diseasestreatmentИсследование проведено в рамках проекта Департамента здравоохранения города Москвы «Научная лаборатория «Московская поликлиника».The study was carried out as part of the project of the Department of Health of the city of Moscow "Scientific laboratory" Moscow polyclinic "".ReferencesГороховский, С. Ю. Эффективность эндоваскулярной коррек­ции выраженных степеней хронических облитерирующих заболева­ний нижних конечностей при многоуровневых поражениях. Пробле­мы здоровья и экологии, 2020. № 1(63). С. 14–20.Gorokhovsky, S. Yu. The effectiveness of endovascular correction of severe degrees of chronic obliterating diseases of the lower extremities with multilevel lesions. Problems of health and ecology, 2020, № 1(63), pp. 14–20. (In Russ.)Дунаевская С.С. Винник Ю.С. Развитие эндотелиальной дис­функции при облитерирующем атеросклерозе сосудов нижних ко­нечностей и маркеры прогнозирования течения заболевания. Бюлле­тень сибирской медицины, 2017. № 16(1). С. 108–118.Dunaevskaya S.S. Vinnik Yu.S. Development of endothelial dysfunc­tion in obliterating atherosclerosis of the vessels of the lower extremities and markers for predicting the course of the disease. Bulletin of Siberian Medicine, 2017, № 16(1), pp. 108–118. (In Russ.)Иванощук Д.Е., Шахтшнейдер Е.В. Современный взгляд на во­просы атеросклероза. Обзор материалов 84-го конгресса европейского общества атеросклероза. Атеросклероз, 2016. № 12(3). С. 78–84.Ivanoshchuk D.E., Shakhtschneider E.V. Modern view on the is­sues of atherosclerosis. Review of the materials of the 84th Congress of the European Society of Atherosclerosis. Atherosclerosis, 2016. № 12(3), pp. 78–84. (In Russ.)Карпов Ю.А. Атеросклероз артерий нижних конечностей: во­просы терапевтического ведения. Атмосфера. Новости кардиологии, 2021. № 1. С 45–53.Karpov Yu.A. Atherosclerosis of the arteries of the lower extremities: issues of therapeutic management. Atmosphere. Cardiology News, 2021, № 1, рр. 45–53.Кательницкий И.И., Зорькин А.А., Дрожжин Е.В. и др. Возмож­ности и собственный опыт применения ривароксабана в комплекс­ном лечении больных с синдромом критической ишемии нижних конечностей. РМЖ, 2018. № 6(II). С. 85–88.Katelnitsky I.I., Zorkin A.A., Drozhzhin E.V., etc. The possibilities and own experience of using rivaroxaban in the complex treatment of pa­tients with the syndrome of critical ischemia of the lower extremities. RMJ, 2018, № 6(II), pp. 85–88. (In Russ.)Кательницкий И.И., Кательницкий И.И., Ливадняя Е.С., Бож­ко А.В. Стационарзамещающие технологии в лечении пациентов с язвенно-некротическими изменениями при критической ишемии нижних конечностей. Современные проблемы науки и образования, 2019. № 4.Katelnitsky I.I., Katelnitsky I.I., Livadnyaya E.S., Bozhko A.V. Inpa­tient replacement technologies in the treatment of patients with ulcerative-necrotic changes in critical lower limb ischemia. Modern problems of Sci­ence and education, 2019, № 4. (In Russ.)Коваленко В.И., Темерезов Т.Х. и др. Гибридная хирургия в ле­чении пациентов с облитерирующим атеросклерозом артерий ниж­них конечностей (обзор литературы). Трансляционная медицина, 2020. № 7(1). С. 33–38.Kovalenko V.I., Temerezov T.H. et al. Hybrid surgery in the treat­ment of patients with obliterating atherosclerosis of the arteries of the lower extremities (literature review). Translational Medicine, 2020, № 7(1), pp. 33–38. (In Russ.)Кузнецов М.Р., Решетов И.В., Сапелкин С.В., Яснопольская Н.В. Консервативное лечение пациентов с перемежающейся хромотой. Русский медицинский журнал. Медицинское обозрение, 2021. Т. 5. № 4. С. 212–217.Kuznetsov M.R., Reshetov I.V., Sapelkin S.V., Yasnopolskaya N.V. Conservative treatment of patients with intermittent claudication. Rus­sian Medical Journal. Medical Review, 2021, Vol. 5, № 4, pp. 212–217. (In Russ.)Морозов А.М., Ахмедова Д.В., Пономарева И.В., Пельтихина О.В. Рациональный выбор методов обследования облитерирующего атеросклероза сосудов нижних конечностей. Молодежь и медицин­ская наука. Статьи VI Всероссийской межвузовской научно-практи­ческой конференции молодых ученых с международным участием, 2019.Morozov A.M., Akhmedova D.V., Ponomareva I.V., Peltikhina O.V. Rational choice of methods of examination of obliterating atherosclerosis of the vessels of the lower extremities. Youth and medical science. Articles of the VI All-Russian Interuniversity Scientific and Practical Conference of Young Scientists with International participation, 2019. (In Russ.)Поршнева Е.В., Никифорова Л.В. Поварова В.О. Эффектив­ность применения цилостазола у пациентов с перемежающейся хро­мотой. Наука молодых, 2022. Том 10. № 2. 175–186.Porshneva E.V., Nikiforova L.V. Povarova V.O. Efficacy of cilostazol in patients with intermittent claudication. Science of the Young, 2022, Vol. 10, № 2, рр. 175–186. (In Russ.)Савина Н.М. Эффективность ривароксабана в снижении ри­ска развития сердечно-сосудистых осложнений у пациентов с ише­мической болезнью сердца и заболеванием периферических артерий: результаты исследования COMPASS. Кардиология, 2018. № 58(3). С. 94–100.Savina N.M. The effectiveness of rivaroxaban in reducing the risk of cardiovascular complications in patients with coronary heart disease and peripheral artery disease: the results of the COMPASS study. Cardiology, 2018, № 58(3), pp. 94–100. (In Russ.)Темрезов М.Б., Коваленко В.И., Темерезов Т.Х. и др. Гибридная хирургия в лечении пациентов с облитерирующим атеросклерозом артерий нижних конечностей (обзор литературы). Трансляционная медицина, 2020. № 7(1). С. 33–38. https://doi.org/10.18705/2311-4495-2020-7-1-33-38Temrezov M.B., Kovalenko V.I., Temerezov T.H. et al. Hybrid sur­gery in the treatment of patients with obliterating atherosclerosis of the ar­teries of the lower extremities (literature review). Translational Medicine, 2020, № 7(1), pp. 33–38. https://doi.org/10.18705/2311-4495-2020-7-1-33-38 (in Russ.)Шабунин А.В., Матвеев Д.В., Кузнецов М.Р., Матвеев А.Д. Консервативное лечение хронической ишемии нижних конечностей в практике амбулаторного хирурга. Хирургия. Журнал им. Н.И. Пиро­гова, 2019. № 3. С. 98–104.Shabunin A.V., Matveev D.V., Kuznetsov M.R., Matveev A.D. Con­servative treatment of chronic lower limb ischemia in the practice of an outpatient surgeon. Surgery. Journal named after N.I. Pirogov, 2019, № 3, pp. 98–104. (In Russ.)Aboyans V, Ricco J.B., Bartelink MEL, et al. 2017 ESC guide­lines on the diagnosis and treatment of peripheral arterial diseas­es, in collaboration with the European Society for Vascular Surgery (ESVS). document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur. Heart. J., 2018, № 39, pp. 763– 816.Aboyans V, Ricco J.B., Bartelink MEL, et al. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). document cover­ing atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Pe­ripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur. Heart. J., 2018, № 39, pp. 763– 816.Anand S.S., Bosch J., Eikelboom J.W., et al. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. Lan­cet, 2018, № 391, pp. 219–229.Anand S.S., Bosch J., Eikelboom J.W., et al. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. Lan­cet, 2018, № 391, pp. 219–229.Brown T., Forster R.B., Cleanthis M., Mikhailidis D.P., Stansby G., Stewart M. Cilostazol for intermittent claudication. Cochrane Database Syst Rev., 2021, № 6, CD003748. https://doi.org/10.1002/14651858.CD003748 pub5, PMID:34192807Brown T., Forster R.B., Cleanthis M., Mikhailidis D.P., Stansby G., Stewart M. Cilostazol for intermittent claudication. Cochrane Database Syst Rev., 2021, № 6, CD003748. https://doi.org/10.1002/14651858.CD003748 pub5, PMID:34192807Campia U., Gerhard-Herman M., Piazza G., Goldhaber S. Z. Pe­ripheral Artery Disease: Past, Present, and Future. Am. J. Med., 2019, Oct, № 132(10), pp. 1133–1141. https://doi.org/10.1016/j.amjmed.2019.04.043 Epub 2019 May 29.Campia U., Gerhard-Herman M., Piazza G., Goldhaber S. Z. Pe­ripheral Artery Disease: Past, Present, and Future. Am. J. Med., 2019, Oct, № 132(10), pp. 1133–1141. https://doi.org/10.1016/j.amjmed.2019.04.043 Epub 2019 May 29.Corrado E., Mignano A.., Coppola G.. Use of statins in patients with peripheral artery disease. Trends Cardiovasc. Med., 2020, № 30(5), pp. 257–262. https://doi.org/10.1016/j.tcm.2019.07.002 Epub 2019 Jul 8.Corrado E., Mignano A.., Coppola G.. Use of statins in patients with peripheral artery disease. Trends Cardiovasc. Med., 2020, № 30(5), pp. 257–262. https://doi.org/10.1016/j.tcm.2019.07.002 Epub 2019 Jul 8.Creager M. A., Bonaca M. P. Pathology of arterial disease in limb loss. J. Am. Coll. Cardiol., 2018, Oct, № 72 (18), pp. 2164–2165.Creager M. A., Bonaca M. P. Pathology of arterial disease in limb loss. J. Am. Coll. Cardiol., 2018, Oct, № 72 (18), pp. 2164–2165.Debus E.S., Nehler M.R., Govsyeyev N., Bauersachs R.M., Anand S.S., Patel M.R., Fanelli F., Capell W.H., Brackin T., Hinterreiter F., Krievins D., Nault P., Piffaretti G., Svetlikov A., Jaeger N., Hess C.N., Sillesen H.H., Conte M., Mills J., Muehlhofer E., Haskell L.P., Berkowitz S.D., Hiatt W.R., Bonaca M.P. Effect of Rivaroxaban and Aspirin in patients with peripher­al artery disease undergoing surgical revascularization: Insights from the VOYAGER PAD Trial. Circulation, 2021, № 5;144(14), pp1104–1116.Debus E.S., Nehler M.R., Govsyeyev N., Bauersachs R.M., Anand S.S., Patel M.R., Fanelli F., Capell W.H., Brackin T., Hinterreiter F., Krievins D., Nault P., Piffaretti G., Svetlikov A., Jaeger N., Hess C.N., Sillesen H.H., Conte M., Mills J., Muehlhofer E., Haskell L.P., Berkowitz S.D., Hiatt W.R., Bonaca M.P. Effect of Rivaroxaban and Aspirin in patients with peripheral artery disease undergoing surgical revascularization: Insights from the VOYAGER PAD Trial. Circulation, 2021, № 5;144(14), pp1104–1116.Di Minno G., Spadarella G., Cafaro G., Petitto M., Lupoli R., Di Minno A, de Gaetano G, Tremoli E. Systematic reviews and meta-analyses for more profitable strategies in peripheral artery disease. Ann Med., 2014, Nov; № 46(7), pp. 475–489. https://doi.org/10.3109/07853890.2014.932618.Di Minno G., Spadarella G., Cafaro G., Petitto M., Lupoli R., Di Minno A, de Gaetano G, Tremoli E. Systematic reviews and meta-analyses for more profitable strategies in peripheral artery disease. Ann Med., 2014, Nov; № 46(7), pp. 475–489. https://doi.org/10.3109/07853890.2014.932618.Dittman J. M., Amendola M. F., Lavingia K. S.. Medical opti­mization of the peripheral artery disease patient. Seminars in Vascular Surgery, 2022, № 35(2), pp. 113–123. https://doi.org/10.1053/j.semvasc­surg.2022.04.003Dittman J. M., Amendola M. F., Lavingia K. S.. Medical opti­mization of the peripheral artery disease patient. Seminars in Vascular Surgery, 2022, № 35(2), pp. 113–123. https://doi.org/10.1053/j.semvasc­surg.2022.04.003Dua A., Gologorsky R., Savage D., Rens N. et al. National assess­ment of availability, awareness, and utilization of supervised exercise ther­apy for peripheral artery disease patients with intermittent claudication. Journal of Vascular Surgery, 2020, Vol. 71, № 5, pp. 1702–1707.Dua A., Gologorsky R., Savage D., Rens N. et al. National assess­ment of availability, awareness, and utilization of supervised exercise ther­apy for peripheral artery disease patients with intermittent claudication. Journal of Vascular Surgery, 2020, Vol. 71, № 5, pp. 1702–1707.Farhan S., Kamran H., Birgit Vogel , Karan Garg, Ajit Rao, Navneet Narula, Glenn Jacobowitz, Arthur Tarricone, Vishal Kapur. Considerations for patients with peripheral artery disease during the COVID-19 pandemic. Clin. Appl. Thromb. Hemost., 2021, Jan-Dec, № 27, рр. 1076029620986877.Farhan S., Kamran H., Birgit Vogel , Karan Garg, Ajit Rao, Navneet Narula, Glenn Jacobowitz, Arthur Tarricone, Vishal Kapur. Con­siderations for patients with peripheral artery disease during the CO­VID-19 pandemic. Clin. Appl. Thromb. Hemost., 2021, Jan-Dec, № 27, рр. 1076029620986877Firnhaber J. M., Powell. C. S. Lower extremity peripheral artery disease: diagnosis and treatment. Am. Fam. Physician, 2019, № 15; 99(6), pp. 362–369.Firnhaber J. M., Powell. C. S. Lower extremity peripheral artery dis­ease: diagnosis and treatment. Am. Fam. Physician, 2019, № 15; 99(6), pp. 362–369.Hogan S.E., Nehler M.R., Anand S., Patel M.R., Debus S., Jackson M.T., Buchanan C., King R.W., Hess C., Muehlhofer E., Haskell L.P., Bauer­sachs R.M., Berkowitz S.D., Hsia J., Bonaca M.P. Improvement in walking impairment following surgical and endovascular revascularization: Insights from VOYAGER PAD. Vasc Med., 2022 Aug; № 27(4), рр. 343–349. https://doi.org/10.1177/1358863X221085606 Epub 2022 Apr 25.Hogan S.E., Nehler M.R., Anand S., Patel M.R., Debus S., Jackson M.T., Buchanan C., King R.W., Hess C., Muehlhofer E., Haskell L.P., Bauer­sachs R.M., Berkowitz S.D., Hsia J., Bonaca M.P. Improvement in walking impairment following surgical and endovascular revascularization: Insights from VOYAGER PAD. Vasc Med., 2022 Aug; № 27(4), рр. 343–349. https://doi.org/10.1177/1358863X221085606 Epub 2022 Apr 25.Jansen-Chaparro S., López-Carmona M. D., Cobos-Palacios L. et al. Statins and peripheral arterial disease: a narrative review. Front. Cardiovasc. Med., 2021, Vol.8, art. 777016. https://doi.org/10.3389/fcvm.2021.777016.Jansen-Chaparro S., López-Carmona M. D., Cobos-Palacios L. et al. Statins and peripheral arterial disease: a narrative review. Front. Cardiovasc. Med., 2021, Vol.8, art. 777016. https://doi.org/10.3389/fcvm.2021.777016.Lu Gao, Wei Zhao, Qi Liu, Mingzhao Qin.. Association between metabolic syndrome and peripheral arterial disease in elderly patients with type 2 diabetes. Diabetes Metab Syndr Obes., 2021, Dec 14; № 14, pp. 4783– 4789. https://doi.org/10.2147/DMSO.S343441.eCollection2021.Lu Gao, Wei Zhao, Qi Liu, Mingzhao Qin.. Association between metabolic syndrome and peripheral arterial disease in elderly patients with type 2 diabetes. Diabetes Metab Syndr Obes., 2021, Dec 14; № 14, pp. 4783– 4789. https://doi.org/10.2147/DMSO.S343441.eCollection2021.Martinez-Singh K., Chandra V. How to build a limb salvage program. Seminars in Vascular Surgery, 2022, Vol. 35(2), pp. 228–233. https://doi.org/10.1053/j.semvascsurg.2022.04.011Martinez-Singh K., Chandra V. How to build a limb salvage program. Seminars in Vascular Surgery, 2022, Vol. 35(2), pp. 228–233. https://doi.org/10.1053/j.semvascsurg.2022.04.011McDermott M. M. Reducing disability in peripheral artery disease: the role of revascularization and supervised exercise therapy. Cardiovasc. Interv., 2019, Jun 24; № 12(12), pp. 1137–1139. https://doi.org/10.1016/j.jcin.2019.03.017McDermott M. M. Reducing disability in peripheral artery disease: the role of revascularization and supervised exercise therapy. Cardiovasc. Interv., 2019, Jun 24; № 12(12), pp. 1137–1139. https://doi.org/10.1016/j.jcin.2019.03.017McDivitt J.D., Braun M., Kassop D. Cardiovascular Disease: Lower extremity peripheral artery disease. FP Essent., 2019, Apr, № 479, pp. 11–15.McDivitt J.D., Braun M., Kassop D. Cardiovascular Disease: Lower extremity peripheral artery disease. FP Essent., 2019, Apr, № 479, pp. 11–15.Miranda J. A., Chung J., Mills .J. L. Influence of the COVID-19 pandemic on the management of chronic limb-threatening ischemia. Sem. Vasc. S., 2021), № 34, pp. 89–95.Miranda J. A., Chung J., Mills .J. L. Influence of the COVID-19 pandemic on the management of chronic limb-threatening ischemia. Sem. Vasc. S., 2021), № 34, pp. 89–95.Narula N., Dannenberg A.J., Olin J.W., et al. Pathology of peripher­al artery disease in patients with critical limb ischemia. J. Am. Coll. Cardiol., 2018, № 72, pp. 2152–63.Narula N., Dannenberg A.J., Olin J.W., et al. Pathology of peripher­al artery disease in patients with critical limb ischemia. J. Am. Coll. Cardiol., 2018, № 72, pp. 2152–63.Natale F, Capasso R, Casalino A, et al. Peripheral artery disease and abdominal aortic aneurysm: the forgotten diseases in COVID-19 pan­demic. Results from an Observational Study on Real-World Management. Medicina (Kaunas), 2021, Jun 29; № 57(7), pp. 672.Natale F, Capasso R, Casalino A, et al. Peripheral artery disease and abdominal aortic aneurysm: the forgotten diseases in COVID-19 pan­demic. Results from an Observational Study on Real-World Management. Medicina (Kaunas), 2021, Jun 29; № 57(7), pp. 672.Onuegbu A., Roy S., Budoff M. Editorial commentary: Peripheral arterial disease and statin therapy, what do we know after all these years? Trends in Cardiovascular Medicine, 2020, Vol. 30, № 5, pp. 263–264.Onuegbu A., Roy S., Budoff M. Editorial commentary: Peripheral arterial disease and statin therapy, what do we know after all these years? Trends in Cardiovascular Medicine, 2020, Vol. 30, № 5, pp. 263–264.Paisley M. J., AdkarBrian S., Sheehan M., Stern J. R.. Aortoiliac oc­clusive disease. Seminars in Vascular Surgery, 2022, Vol. 35, № 2, pp. 162– 171.Paisley M. J., AdkarBrian S., Sheehan M., Stern J. R.. Aortoiliac oc­clusive disease. Seminars in Vascular Surgery, 2022, Vol. 35, № 2, pp. 162– 171.Peters F., Kuchenbecker J., Kreutzburg T., Marschall U., Debus E. S., Behrendt C.-A. Long-Term effectiveness and safety of initiating statin therapy after index revascularization in patients with peripheral arterial oc­clusive disease. J Am Heart Assoc., 2020, Nov, № 17; 9(22), р. 018338. https://doi.org/10.1161/JAHA.120.018338 Epub 2020 Nov 13.Peters F., Kuchenbecker J., Kreutzburg T., Marschall U., Debus E. S., Behrendt C.-A. Long-Term effectiveness and safety of initiating statin therapy after index revascularization in patients with peripheral arte­rial occlusive disease. J Am Heart Assoc., 2020, Nov, № 17; 9(22), р. 018338. https://doi.org/10.1161/JAHA.120.018338 Epub 2020 Nov 13.Polonsky T. S, McDermott M. M. Lower extremity peripheral artery disease without chronic limb-threatening ischemia: A Review. JAMA, 2021, Jun 1; № 325(21), pp. 2188–2198. https://doi.org/10.1001/jama.2021.2126Polonsky T. S, McDermott M. M. Lower extremity peripheral artery disease without chronic limb-threatening ischemia: A Review. JAMA, 2021, Jun 1; № 325(21), pp. 2188–2198. https://doi.org/10.1001/jama.2021.2126Treat-Jacobson D., Mary M., McDermott, et al. Optimal exercise programs for patients with peripheral artery disease: a scientific state­ment from the American Heart Association. Circulation, 2019, № 139, pp. 10–33.Treat-Jacobson D., Mary M., McDermott, et al. Optimal exercise programs for patients with peripheral artery disease: a scientific statement from the American Heart Association. Circulation, 2019, № 139, pp. 10–33.

The authors declare that there are no conflicts of interest present.