CCS PAD 2022

Question 1

Who should be screened for ABI if asymptomatic?

Answer 1

> 50 years who have risk factors (Smoking, T2DM)

Question 2

two ways to confirm the diagnosis of PAD?

Answer 2

• TBI

- ABI

Question 3

Review ABI results

Answer 3

Question 4

What is se and sp for ABI < 0.9 for PAD? TBI < 0.6 ?

Answer 4

ABI < 0.9 = Se 61%, Sp 92%

TBI < 0.6 = Se 81%, Sp 77%

Question 5

Should patients with PAD get screening for CAD/Carotids?

Answer 5

No (if no symptoms)

Question 6

Should patients with DM and PAD get SGLT2 inhibitor ?

Answer 6

Yes- There is less MACE events, without any increased risk of amputation

Question 7

BP target for PAD?

Answer 7

140/90 mmhg (In SPRINT, in patients with PAD there was increased risk of primary outcome with aggressive BP control.)

Question 8

Do patients with aymptomatic PAD need ASA?

Answer 8

No

Question 9

Is ASA or Plavix preferred for monotherapy?

Answer 9

Plavix

Question 10

What is Antithrombotic therapy post elective revascularization?

Answer 10

• ASA
• Rivaroxaban 2.5mg bid
• +/- clopidogrel

Question 11

What is anti thrombotic strategy for emergent/urgent revascularization?

Answer 11

-Full dose anticoagulation in combination with SAPT OR Rivaroxaban low dose and ASA +/- short term clopidogrel OR DAPT

Question 12

Should RCRI be used to preoperative assessment for PAD revascularization?

Answer 12

No

Question 13

Should BNP be used for peri op risk stratification?

Answer 13

Yes

Question 14

Who to revascularize?

Answer 14

High burden symptoms, nonoperative therapy failed (lifestyle, exercise, medical therapy)

Question 15

What two arteries should you not do endovascular therapy in?

Answer 15

Common femoral or profunda femoris

Question 16

6 factors that favor endovascular repair compared to open?

Answer 16

• Focal aortoiliac occlusive disease
• Focal femoropopliteal disease
• Intermittent claudication indication
• Inadequate vein conduit for bypass
• Prohibitive surgical risk
• Expected survival < 2 years

Question 17

What to use in place of RCRI in PAD patients?

Answer 17

VSG-RCI

Age > 80 (4)
Age 70-79 (3)
Age 60-69 (2)
CAD (2)
CHF (2)
COPD (2) 
Cr > 1.8 (2)
Smoking (1)
IDDM (1)
Beta Blockade (1) 
History of CABG/PCI (-1)