1. Post-Surgical Care for the Individual With PAD: A Shared Responsibility to Sustain Life and Limb

2. Post-Surgical Care for the Individual With PAD
Unless contraindicated, all patients
undergoing revascularization for CLI should be placed on antiplatelet therapy, and this treatment should be continued indefinitely.
Patients who have undergone placement of aortobifemoral bypass grafts should be
followed up with periodic evaluations that
record any return or progression of ischemic symptoms, the presence of femoral pulses, and ABIs. I
IIa
IIb
III B

3. Post-Surgical Care for the Individual With PAD: Autogenous Vein Bypass
IIa
IIb
III A
Patients who have undergone placement of a lower extremity bypass with autogenous vein should undergo for at least 2 years periodic examinations that record any return or progression of ischemic symptoms; a physical examination, with concentration on pulse examination of the proximal, graft, and outflow vessels; and Duplex imaging of the entire length of the graft, with measurement of peak systolic velocities and calculation of velocity ratios across all lesions.

4. Post-Surgical Care for the Individual With PAD: Synthetic Vein Bypass
IIa
IIb
III A
Patients who have undergone placement of a synthetic lower extremity bypass graft should undergo periodic examinations that record any return of ischemic symptoms; a pulse examination of the proximal, graft, and outflow vessels; and assessment of ABIs at rest and after exercise for at least 2 years after implantation.

5. Post-Surgical Care for the Individual With PAD: Critical Limb Ischemia
IIa
IIb
III C
Patients with a prior history of CLI or who
have undergone successful treatment for CLI
should be evaluated at least twice annually
by a vascular specialist owing to the relatively
high incidence of recurrence.

6. The PAD Guideline is Intended to Guide Lifelong Primary to Specialty PAD Care
Population remains at risk:
Primary care
management of
legs and life, in
collaboration with
vascular specialists
Population at risk:
(Age and risk factors)
Establish the PAD diagnosis
Population with symptoms:
Improve limb outcomes
Prevent CV ischemic events
ABI
TBI
Duplex US
MRA
CTA
Angiography
Medical
Therapy
Endovascular
Therapy
Surgical
Therapy
Integrated care requires a partnership of vascular specialists (vascular medicine, cardiology, interventional radiology, nursing, podiatry, and others)
ABI=ankle-brachial index; CTA=computed tomographic angiography; CV=cardiovascular; MRA=magnetic resonance angiography; TBI=toe-brachial index;
US= ultrasound.

7. The PAD Guideline: Diverse Platforms For Diverse Users
The Pocket Guide is:
A concise summary of the key recommendations & clinical algorithms
Provides the central “to do” goals for each PAD syndrome
Is appropriate for clinicians in practice and trainees

8. Intersocietal Guidelines for the Management of PAD: Major Contributions to Improved Care Standards
Population at risk is now defined by epidemiologic criteria applied to practice.
Presentation-specific algorithms will expedite care (e.g., asymptomatic, atypical leg pain, classic claudication, critical limb ischemia, and acute arterial occlusion).
Use of exercise, pharmacologic, endovascular, and surgical interventions are emplaced in care as defined by evidence.

9. The Ideal Clinical Synergy:
When an Informed Patient Seeks an Informed Clinician
The PAD Coalition & PAD Guideline
Public Awareness of
Peripheral Artery
Disease
Clinician Awareness of
Peripheral Artery
Disease
Individual “at risk” or with PAD
seeks care (primary care)
Individual “at risk” or with PAD
receives vascular care

10. public and physician education.
Toward Increased Public Awareness and Education of PAD in North America
The PAD Coalition
A public, interdisciplinary, not-for-profit Coalition devoted to creating a national PAD public awareness campaign and to coordinating PAD
public and physician education.

11. Clearinghouse for PAD educational resources:
Clearinghouse for PAD educational resources:
Clinical practice tools
Slides
Patient education resources
Professional meetings
PAD Coalition news

12. “Stay in Circulation: Take Steps to Learn About PAD”
“Stay in Circulation: Take Steps to Learn About PAD”
Campaign Website
Community Action Toolkit
Media Resources
Fact Sheets
Posters
“Patient Stories” Video
Radio and print ads