t can't be altered are the sex, age, race, and family history of heart disease. Atherosclerosis leading to Arteriosclerosis Obliteerans develops more often and earlier in people with diabetes mellitus, especially if that person smokes.
             Symptoms usually do not occur until 60 % of the lumen is occluded.
             -intermittent claudication (calf & foot ; may radiate)
             -diminished or absent femoral or distal pulses
             -no palpable pulses in ankles or feet
             -pain in calf (cramp) in dorsiflexion
             -dietary management (low sodium & fat)
             -pain control (MS, Tylenol, Tylenol #3)
             -daily walking ( to improve collateralization & walking)
             -provide attention to skin care (avoid ulceration & infections)
             -low-dose aspirin (antiplatelet agent)
             -Anticoagulant therapy- coumadin, h.l.
             -Doppler ultrasonography (accurately determine arterial blood pressure)
             -transcutaneous oximetry to elevate pressure and oxygenation
             -x-rays of the leg & foot to show calcification of the vessel
             -Aortography(view the level & extent of the occlusion & to determine the condition of the vessels distal to the block.
             -MR (magnetic resonance) angiography -used to show the same information without use of contrast medium.
             -monitor pedal pulses Q 4 hr with Doppler
             -administer medications( MS, Tylenol, Tylenol #3) as ordered by the physician
             -encourage ambulation with asst. in hallway for 10 min. bid
             -laser angioplasty (A guide catheter is threaded into the diseased coronary artery to the narrowed area. A laser catheter is inserted. The laser is then activated and converts electrical energy into ultraviolet light. The light vaporizes the p
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