Fast Five Quiz: Refresh Your Knowledge of Key Aspects of Peripheral Artery Disease

Yasmine S. Ali, MD, MSCI

Disclosures

July 05, 2018

AHA/ACC guidelines include:

  • The vascular examination for PAD includes pulse palpation, auscultation for femoral bruits, and inspection of the legs and feet; lower-extremity pulses are assessed and rated as: 0, absent; 1, diminished; 2, normal; or 3, bounding

  • To confirm the diagnosis of PAD, abnormal physical examination findings must be confirmed with diagnostic testing, generally with the ABI as the initial test

  • Patients with confirmed diagnosis of PAD are at increased risk for subclavian artery stenosis; an interarm blood pressure difference of > 15 to 20 mm Hg is abnormal and suggestive of subclavian (or innominate) artery stenosis; measuring blood pressure in both arms identifies the arm with the highest systolic pressure, a requirement for accurate measurement of the ABI

  • The ABI is not recommended in patients who are not at increased risk for PAD and who do not have a history or physical examination findings suggestive of PAD

  • Toe-brachial index (TBI) should be measured to diagnose patients with suspected PAD when the ABI is >1.40

  • Patients with exertional nonjoint-related leg symptoms and normal or borderline resting ABI should undergo exercise treadmill ABI testing to evaluate for PAD

  • Patients with PAD should receive a comprehensive program of guideline-directed medical therapy, including structured exercise and lifestyle modification, to reduce cardiovascular ischemic events and improve functional status

  • Treatment with a statin medication is indicated for all patients with PAD

  • Patients with PAD who smoke cigarettes or use other forms of tobacco should be advised at every visit to quit

  • Cilostazol is an effective therapy to improve symptoms and increase walking distance in patients with claudication

  • When surgical revascularization is performed, bypass to the popliteal artery with autogenous vein is recommended in preference to prosthetic graft material

For more on the guidelines for PAD, read here.

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