Patterns of Disease

in Lower Extremity Arterial Disease

Applied

Type

Modification

Confidence

92%

Created

Apr 26, 2026

Evidence

2 sources

Rationale

The 2026 ACC/AHA Lower Extremity PAD guideline (PMID 41252847) supersedes the previously cited acc 2025 for the claim about DM-associated distal, multi-level disease and medial arterial calcification. Per the stale guideline replacement instructions, the stale citation has been replaced with ACC/AHA rather than co-cited, as both support the same claim. All other content and citations are preserved unchanged.

Evidence

Textbook proof

The triad of intermittent claudication, impotence, and absent femoral pulses is associated with aortoiliac occlusion and is often referred to as Leriche syndrome.

Content Changes

* Aortoiliac: Leriche syndrome (claudication, impotence, absent femoral pulses).[@rutherford2018-rutherford]pulses).[@rutherford-10e-2022-ch19-clinical-evaluation-of-the-arter-p309-90299d0f]
* Femoropopliteal: most common site.
* Infrapopliteal/tibial: common in diabetes mellitus (DM) and renal failure, often presenting as chronic limb-threatening ischemia (CLTI).[@ahaacc2016] Patients with DM typically exhibit more distal, multi-level disease patterns and increased medial arterial calcification (MAC).[@acc2025](MAC).[@acc2026]