Peripheral arterial disease; guidelines; management; training
Abstract :
[en] The new guidelines for the management of peripheral arterial and aortic diseases (PAAD) from the European Society of Cardiology and endorsed by the European Society of Vascular Medicine (ESVM), emphasize on a comprehensive and multidisciplinary approach focusing on prevention, diagnosis, treatment, and follow-up of patients with a wide range of PAAD, including lower extremity peripheral arterial disease (PAD). The aim of this summary, focusing on PAD and coordinated by the Young Academy of ESVM, is to provide young angiologists with the fundamental principles of these guidelines and to assist them in navigating their everyday clinical practice. PAD diagnosis relies on objective evaluation of flow/oxygen reduction at rest, with arterial ultrasound as the first imaging modality to confirm the presence of arterial lesions. The main goals of PAD management are not only to improve functioning and prevent the occurrence of adverse events at the lower limb level, but also to reduce the overall atherosclerotic burden and achieve the general well-being of patients. To this end, traditional and nontraditional cardiovascular risk factors need to be properly addressed through lifestyle changes and tailored drug therapies. For patients with exertional limb symptoms, supervised exercise training is recommended. Interventional treatment is indicated for limb salvage in patients with chronic limb threatening ischemia and may also be discussed in a multidisciplinary setting in less severe patients with persisting symptoms and reduced quality of life after a minimum period of optimal medical treatment including exercise therapy. For trainees or young specialists in Angiology/Vascular Medicine, these guidelines provide essential elements to improve patient management, encourage interdisciplinary collaboration, and ensure an integrated approach to vascular diseases.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Buso, Giacomo ; Department of Clinical and Experimental Sciences, Division of Internal Medicine, ASST Spedali Civili Brescia, University of Brescia, Italy ; University of Lausanne, Switzerland
Hersant, Jeanne ; Department of Vascular Medicine, University Hospital of Angers, France
Keller, Sanjiv ; Angiology Division, Heart and Vessel Department, Lausanne University Hospital, University of Lausanne, Switzerland
Kalaja, Igli ; Department for Cardiology III - Angiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
Bigolin, Paola ; Angiology Unit, Azienda ULSS 2 Marca Trevigiana, Castelfranco Veneto, Italy
Porceddu, Enrica; Angiology Division, Heart and Vessel Department, Lausanne University Hospital, University of Lausanne, Switzerland
Ghirardini, Francesca; Angiology Unit, AULSS 1 Dolomiti, San Martino Hospital, Belluno, Italy
Novaković, Marko ; Department of Vascular Diseases, University Medical Centre Ljubljana, Slovenia
Meilak, Darren Galea; Vascular Unit, Mater Dei Hospital, Malta
Džupina, Andrej; Department of Cardiology and Angiology, National Institute of Cardiovascular Diseases, Bratislava, Slovakia
Gary, Thomas; Division of Angiology, Department of Internal Medicine, Medical University of Graz, Austria
Bura-Rivière, Alessandra; Department of Vascular Medicine, Toulouse University Hospital, France ; Department of Medicine, Faculté de Santé Université Toulouse III, France
Heiss, Christian ; Vascular Department, Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Redhill, UK ; Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
Lanzi, Stefano ; Angiology Division, Heart and Vessel Department, Lausanne University Hospital, University of Lausanne, Switzerland
Madaric, Juraj ; Department of Angiology, Comenius University and National Institute of Cardiovascular Diseases, Bratislava, Slovakia
Boc, Vinko ; Department of Vascular Diseases, University Medical Centre Ljubljana, Slovenia ; Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Slovenia
Sprynger, Muriel ; Université de Liège - ULiège > Département des sciences cliniques
Mirault, Tristan; Université Paris Cité, PARCC Inserm U970, CRMR MARS, VASCERN, Vascular Medicine, Hôpital Européen Georges-Pompidou APHP, Paris, France
Brodmann, Marianne; Division of Angiology, Department of Internal Medicine, Medical University of Graz, Austria
Schlager, Oliver ; Division of Angiology, Department of Medicine II, Medical University of Vienna, Austria
Mazzolai, Lucia; Angiology Division, Heart and Vessel Department, Lausanne University Hospital, University of Lausanne, Switzerland
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