Download PDF
Int J Angiol
DOI: 10.1055/a-2792-9544
Review Article

The Role of Arterial Stiffness in the Prognosis, Assessment, and Treatment of Patients with Peripheral Artery Disease: A Comprehensive Review

Authors

  • Pouya Tayebi 

    1   Department of Vascular and Endovascular Surgery, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
    2   Clinical Research Development Unit, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
Further Information
   Permissions and Reprints

Abstract

Peripheral artery disease (PAD) is a prevalent and disabling vascular condition characterized by progressive atherosclerotic narrowing and stiffening of peripheral arteries. Arterial stiffness, most accurately measured by pulse wave velocity (PWV), has gained prominence as a critical biomarker in the assessment and management of PAD. Unlike traditional diagnostic tools that focus primarily on anatomical lesions, PWV offers dynamic insights into vascular function, elasticity, and systemic cardiovascular risk. Elevated PWV has been consistently associated with adverse outcomes in PAD patients, including critical limb ischemia, restenosis following angioplasty, amputation, and cardiovascular mortality. It not only reflects disease severity but also facilitates early risk stratification, informs treatment selection, and enables monitoring of therapeutic efficacy. Studies have shown that reductions in arterial stiffness following angioplasty, pharmacological therapy, or lifestyle interventions correlate with improved limb perfusion and long-term clinical outcomes. Moreover, in elderly PAD patients, arterial stiffness often coexists with frailty—another key predictor of poor prognosis. Emerging evidence suggests that both conditions may share pathophysiological pathways related to vascular aging and sarcopenia. The integration of PWV into routine PAD evaluation may thus offer a more holistic understanding of patient risk and resilience. Given its diagnostic, prognostic, and therapeutic utility, arterial stiffness—particularly as assessed by PWV—should be considered an essential parameter in PAD management. Incorporating this measurement into clinical practice holds significant potential to improve individualized care, reduce complications, and enhance overall patient outcomes.

Keywords

peripheral artery disease - vascular stiffness - pulse wave velocity - vascular diseases - atherosclerosis - lower extremity - risk factors


Publication History

Received: 08 January 2026

Accepted: 19 January 2026

Article published online:
06 February 2026

© 2026. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA