Revascularization for claudication in lower extremity peripheral arterial disease

Jump to navigation Jump to search


Peripheral arterial disease Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Peripheral arterial disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Guidelines for Management

Case Studies

Case #1

AHA/ACC Guidelines on Management of Lower Extremity PAD

Guidelines for Clinical Assessment of Lower Extremity PAD

Guidelines for Diagnostic Testing for suspected PAD

Guidelines for Screening for Atherosclerotic Disease in Other Vascular Beds in patients with Lower Extremity PAD

Guidelines for Medical Therapy for Lower Extremity PAD

Guidelines for Structured Exercise Therapy for Lower Extremity PAD

Guidelines for Minimizing Tissue Loss in Lower Extremity PAD

Guidelines for Revascularization of Claudication in Lower Extremity PAD

Guidelines for Management of CLI in Lower Extremity PAD

Guidelines for Management of Acute Limb Ischemial in Lower Extremity PAD

Guidelines for Longitudinal Follow-up for Lower Extremity PAD

Revascularization for claudication in lower extremity peripheral arterial disease On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Revascularization for claudication in lower extremity peripheral arterial disease

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Revascularization for claudication in lower extremity peripheral arterial disease

CDC on Revascularization for claudication in lower extremity peripheral arterial disease

Revascularization for claudication in lower extremity peripheral arterial disease in the news

Blogs on Revascularization for claudication in lower extremity peripheral arterial disease

Directions to Hospitals Treating Peripheral arterial disease

Risk calculators and risk factors for Revascularization for claudication in lower extremity peripheral arterial disease

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease[1]

Recommendation for Revascularization for Claudication in the Patient with PAD

Class IIa
"1. Revascularization is a reasonable treatment option for the patient with lifestyle limiting claudication with an inadequate response to GDMT.(Level of Evidence: A)"

Recommendations for Endovascular Revascularization for Claudication:

Class I
"1. Endovascular procedures are effective as a revascularization option for patients with lifestyle-limiting claudication and hemodynamically significant aortoiliac occlusive disease.(Level of Evidence: A)"
Class III (Harm)
"1. Endovascular procedures should not be performed in patients with PAD solely to prevent progression to CLI.(Level of Evidence: B-NR)"
Class IIa
"1.Endovascular procedures are reasonable as a revascularization option for patients with lifestyle-limiting claudication and hemodynamically significant femoropopliteal disease.(Level of Evidence: B-R)"
Class IIb
"1.The usefulness of endovascular procedures as a revascularization option for patients with claudication due to isolated infrapopliteal artery disease is unknown.(Level of Evidence: C-LD)"

Recommendations for Surgical Revascularization for Claudication:

Class I
"1. When surgical revascularization is performed, bypass to the popliteal artery with autogenous vein is recommended in preference to prosthetic graft material.(Level of Evidence: A)"
Class III (Harm)
"1. Femoral-tibial artery bypasses with prosthetic graft material should not be used for the treatment of claudication.(Level of Evidence: B-R)"
"2. Surgical procedures should not be performed in patients with PAD solely to prevent progression to CLI.(Level of Evidence: B-NR)"
Class IIa
"1.Surgical procedures are reasonable as a revascularization option for patients with lifestyle-limiting claudication with inadequate response to GDMT, acceptable perioperative risk, and technical factors suggesting advantages over endovascular procedures.(Level of Evidence: B-NR)"

References

  1. Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE; et al. (2016). "2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Circulation. doi:10.1161/CIR.0000000000000471. PMID 27840333.