Peripheral artery disease guide
Snapshot
- Typical symptoms: Exertional calf/thigh pain, reduced walking distance, delayed wound healing.
- High-risk profile: Diabetes, tobacco use, CKD, hypertension, hyperlipidemia.
Initial workup
- Resting ABI for suspected PAD.
- Pulse exam, skin/foot exam, ulcer assessment.
- Consider vascular referral for severe symptoms, rest pain, or tissue loss.
Treatment priorities
- Antiplatelet therapy when indicated.
- High-intensity statin unless contraindicated.
- Optimize BP, glucose, and tobacco cessation.
- Structured walking program and supervised exercise when available.
Escalation triggers
- Rest pain, non-healing ulcers, gangrene, rapidly declining function.
- ABI decline with worsening symptoms.
Follow-up cadence
- Reassess walking tolerance, wound status, med adherence, and smoking status every 4–12 weeks during active management.