An Update on Diagnosing & Treating PAD

Peripheral arterial disease (PAD) is a common and dangerous condition that affects millions of Americans, especially those with a history of diabetes or smoking. Despite efforts to increase awareness in the medical community, the disease remains largely underdiagnosed. For many patients, PAD is asymptomatic and may not lead to recognizable symptoms. In turn, a diagnosis may be delayed. If left untreated, PAD has been shown in published research to be predictive of heart attack, stroke, leg amputations, and death. In 2005, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA), along with collaborating societies, released guidelines for the management of PAD. In 2011, the ACCF/AHA updated these guidelines to reflect new data in the diagnosis and treatment of the condition. “The 2011 guideline includes new information for diagnosing PAD, smoking cessation, the use of antiplatelet therapy, and interventions for treating severely ischemic limbs and abdominal aortic aneurysms (AAAs),” says Thom W. Rooke, MD, FACC, who chaired the committee that developed the 2011 guidelines. “The update can assist primary care clinicians, cardiologists, pulmonologists, interventional radiologists, vascular surgeons, and vascular medicine specialists in improving patient care.” Diagnosing Peripheral Arterial Disease The 2011 ACCF/AHA guideline includes a recommendation to lower the age at which anklebrachial index (ABI) diagnostic testing should be performed in the practice setting. “Previously, the recommendation was for patients aged 70 or older to receive an ABI,” says Dr. Rooke. “That threshold has been lowered to age 65 or older based on mounting evidence demonstrating that people in this age range have a 20% chance of having either symptomatic or asymptomatic PAD.” Furthermore, ABI diagnostic...