Peripheral vascular disease

Question 1

Management of peripheral vascular disease

Answer 1

Diagnosis established with ankle-brachial index <0.9 or decrease in ABI by 20% after exercise testing

Risk factor control

• Smoking cessation, antihypertensives, statins, glycaemic control HbA1c <7.0 if possible

Antiplatelet therapy - monotherapy appropriate, modest benefit of clopidogrel over aspirin

Symptom management - graded exercise therapy, cilostazol therapy, revascularisation

Question 2

Indications for revascularisation

Answer 2

Ongoing symptoms of claudication despite pharmacological management and lifestyle therapy

Life threatening ischaemia