Abstract
The first choice treatment for critical limb ischemia, the most severe manifestation of peripheral arterial disease (PAD), is revascularization therapy. In contrast, walking exercise with anti-platelet therapy is the best for PAD without critical limb ischemia to improve the ability to walk without claudication for an extended period of time and to prevent from cardiovascular events. Supervised exercise is recommended, although if it is not feasible, home exercise should be started as soon as possible. Mechanisms for improvement of intermittent claudication may be increase in collateral flow and anriogenesis, nitric oxide-dependent vasodilation, increase in mitochondrial energetic and decrease in markers of systemic inflammation. Even after revascularization therapy, exercise should be continued to prevent from cardiovascular events.
