Peripheral arterial disease: diagnosis and management in general practice

Au, Thuy Bich, Golledge, Jonathan, Walker, Philip J., Haigh, Kate, and Nelson, Mark (2013) Peripheral arterial disease: diagnosis and management in general practice. Australian Family Physician, 42 (6). pp. 397-400.

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Background: Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis. It affects 10–15% of the general population, and is often asymptomatic; leading to under-diagnosis and under-treatment. Atherosclerotic risk factors are often not intensively managed in PAD patients.

Objective: To summarise the information around the diagnosis and management of PAD in the general practice setting.

Discussion: Careful history, clinical examination, and measurement of ankle-brachial index remain the initial means of diagnosing PAD. More detailed anatomic information from duplex imaging, computed tomography angiography and magnetic resonance angiography, is usually unnecessary unless endovascular or surgical intervention is being considered, or if abdominal aortic aneurysm or popliteal aneurysm need to be excluded. Management is focused on lifestyle modification, including smoking cessation and exercise; medical management of atherosclerotic risk factors, including antiplatelet agents, statins, antihypertensive therapy; and agents to improve walking distance, such as cilostazol and ramipril. Endovascular or surgical interventions are usually considered for lifestyle limiting intermittent claudication not responding to conservative therapies, and for critical limb ischaemia.

Item ID: 31656
Item Type: Article (Research - C1)
ISSN: 0300-8495
Keywords: peripheral arterial disease, risk factors, health behaviour, risk reduction behaviour
Date Deposited: 26 Feb 2014 10:16
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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