Lower extremity ischemia in adults younger than forty years of age: A community-wide survey of premature atherosclerotic arterial disease

Epidemiology of Peripheral Artery Disease

“…116 Patients with premature PAD (onset of symptoms at or before age 45) seem to have more rapid progression of disease and generally poorer outcomes. [117][118][119][120][121] One study suggested that PAD progression in large arteries was related to smoking, the total cholesterol to HDL-C ratio, lipoprotein(a), and high-sensitivity CRP, but only diabetes mellitus was associated with progression in smaller arteries.…”

Factors associated with early failure of infrainguinal lower extremity arterial bypass

“…16 Numerous studies have found a poor prognosis for this virulent disease because these patients have higher rates of graft failure, reoperations, and amputations. [17][18][19][20][21][22][23] Saltzberg et al 17 studied outcomes in lower extremity revascularization in young diabetic patients and found a 30-day graft failure rate of 11.1%. They postulated that this may be a result of a more aggressive treatment taken in these younger patients with an attempt to perform a bypass to a suboptimal distal target rather than perform a primary amputation.…”

Treatment of Chronic Peripheral Arterial Disease

“…In young adults with premature lower extremity atherosclerosis, smoking was found to be the most prevalent risk factor [14]. The effects of smoking are multifactorial and include direct endothelial cell damage, increased lipid permeability, sympathetic activity, myointimal hyperplasia, and decreased nutritive flow in the vascular wall [15].…”