Cerebral and Peripheral Vascular Disease

The diagnostic and therapeutic considerations discussed earlier apply to the carotid and peripheral vessels with other generalizations and exceptions. Beta-blocker therapy causing bradycardia could provoke neurologic and peripheral symptoms distal to a stenotic lesion. BP control appears to be more important than glycemic control in preventing cerebrovascular accidents (CVAs, strokes). Patients with clau-dication-like stable angina might respond to exercise. Vascular surgery is indicated for patients with nonhealing ulcers and pain at rest. Insulinization promotes vasodilation and improves perfusion and WBC function in patients treated for a nonhealing wound or foot ulcer.

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