AHA/ACC Guideline Addresses Lower Extremity PAD
March 14, 2017—The 2016 American Heart Association/American College of Cardiology (AHA/ACC) guideline on the management of patients with lower extremity peripheral artery disease (PAD) was published online by Marie D. Gerhard-Herman, MD, et al in Journal of the American College of Cardiology and in Circulation in November 2016. Additionally, an executive summary has been published in Journal of the American College of Cardiology (2017;69:1465–1508). Dr. Gerhard-Herman serves as Chair of the Writing Committee for the AHA/ACC task force on clinical practice guidelines.
This guideline addresses clinical assessment for PAD and provides recommendations on: diagnostic testing for patients with suspected lower-extremity PAD (claudication or critical limb ischemia [CLI]), screening for atherosclerotic disease in other vascular beds for patients with PAD, medical therapy, structured exercise therapy, minimizing tissue loss, revascularization for claudication, management of CLI, management of acute limb ischemia, and longitudinal follow-up. Finally, the paper discusses evidence gaps and future research directions in the understanding of PAD treatment.
In the guideline, the writing committee identified three priorities for multisocietal advocacy initiatives to improve health care for patients with PAD: (1) using the ankle-brachial index as the initial diagnostic test to establish the diagnosis of PAD in patients with history or physical examination findings suggestive of PAD; (2) ensuring access to supervised exercise programs for patients with PAD; (3) incorporating patient-centered outcomes into the process of regulatory approval of new medical therapies and revascularization technologies.
Expanded coverage and discussion of the new guideline publication will be included in a future edition of Endovascular Today.