Int J Angiol 2009; 18(1): 45-47
DOI: 10.1055/s-0031-1278323
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Premature peripheral arterial disease – difficult diagnosis in very early presentation

Vijay A. Doraiswamy1 2 , Jay Giri2 , Emile Mohler III2
  • 1University of Arizona College of Medicine, University Physicians Hospital at Kino, Tucson, Arizona
  • 2University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Further Information

Publication History

Publication Date:
28 April 2011 (online)


Peripheral arterial disease (PAD) is defined as an ankle-brachial index of less than 0.9. It is mostly prevalent in patients older than 50 years of age; its occurrence in younger patients is rare. Nevertheless, the diagnosis must be considered in any patient with exertional lower extremity symptoms. Patients with early-onset disease, also called premature PAD, have a particularly difficult course with early involvement of other major arterial beds such as the carotid and coronary arteries. Their diagnosis and treatment have to be comprehensive to prevent early morbidity and mortality. Reports of very early occurrence and management are rare, especially of onset before 25 years of age. Management of this early presentation of PAD is unclear because most of the available information concerns treatment of patients 40 years of age or older. The cases of two patients who developed symptomatic PAD before 25 years of age are described, and the various causes and management options available for the treatment of early onset PAD patients are discussed.