Peripheral arterial disease Flashcards
What is peripheral arterial disease (PAD) strongly linked to?
PAD is strongly linked to smoking.
What should be done for patients with PAD who smoke?
Patients who still smoke should be given help to quit smoking.
What comorbidities should be treated in patients with PAD?
Comorbidities to be treated include hypertension, diabetes mellitus, and obesity.
What medication is recommended for all patients with established cardiovascular disease?
All patients should be taking a statin, with atorvastatin 80 mg currently recommended.
What did NICE publish in 2010 regarding antiplatelet therapy for PAD?
NICE suggested that clopidogrel should be used first-line in preference to aspirin.
What type of program is recommended for patients with PAD?
A supervised exercise programme is recommended for all patients with PAD prior to other interventions.
What are the treatment options for severe PAD or critical limb ischaemia?
Treatment options include endovascular revascularization, surgical revascularization, and amputation.
What endovascular techniques are typically used for PAD?
Endovascular techniques are typically used for short segment stenosis (< 10 cm), aortic iliac disease, and high-risk patients.
What surgical techniques are used for long segment lesions in PAD?
Open surgical techniques are typically used for long segment lesions (> 10 cm), multifocal lesions, lesions of the common femoral artery, and purely infrapopliteal disease.
When should amputation be considered in PAD patients?
Amputation should be reserved for patients with critical limb ischaemia who are not suitable for other interventions.
What drugs are licensed for use in PAD?
Drugs licensed for use in PAD include naftidrofuryl oxalate and cilostazol.
What is the use of naftidrofuryl oxalate in PAD?
Naftidrofuryl oxalate is a vasodilator, sometimes used for patients with a poor quality of life.
What is cilostazol and its effects?
Cilostazol is a phosphodiesterase III inhibitor with both antiplatelet and vasodilator effects, but it is not recommended by NICE.
