Mechanisms of Interaction Between the Blood Coagulation System and Atherosclerosis in Lower Extremity Peripheral Artery Disease

Lower extremity peripheral artery disease (PAD) remains a major medical and social challenge due to its elevated cardiovascular risk and substantial reduction in patient quality of life. This review synthesizes contemporary literature, clinical guidelines, and our own clinical observations. 66 publications were analyzed, predominantly from the past decade, with earlier sources included when they provided foundational or high-value evidence. PAD pathogenesis involves hemostatic disturbances, including platelet activation, endothelial dysfunction, and hypercoagulability, which drive atherosclerosis progression and tissue ischemia. Pharmacological correction of hemostatic abnormalities remains the cornerstone of treatment and prevention of PAD-related complications. Modern clinical trials support an integrated management strategy combining pharmacotherapy, risk-factor control, and lifestyle modification to improve prognosis and quality of life. Future research directions include the development of agents targeting inflammatory pathways and endothelial function, as well as personalized therapeutic approaches based on individual hemostatic profiles and comorbidities. A deeper understanding of the role of the coagulation system in PAD pathogenesis, together with the application of modern pharmacological approaches, may optimize treatment outcomes and reduce the overall disease burden at the population level.

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