Lower limb peripheral arterial disease

This guideline doesn’t change very much that we do already, so I am not including elements that we are all doing already. The new elements for me were:

Assess for Peripheral Arterial Disease (PAD) in:

  • Non-healing Wounds
  • Unexplained Leg Pain
  • Going to undergo leg or foot interventions
  • Compression hosiery (NB it does imply that patients having compression hosiery should have an ABPI done)

Advice given to patients:

Apart from the normal advice, it is worth emphasising that modifying risk factors and exercise really do make a difference. Apparently many patients simple do not believe this to be the case, so if you want them to engage, you need to explain this clearly.

Management:

  • Clopidogrel is the antiplatelet drug of choice for PAD.
  • Supervised Exercise Programme – all patients should have a 3 month programme and surgical management should only be considered after this.
  • Naftidrofuryl oxalate. This should only be used after a supervised exercise programme and if they then decline surgical management.This is the only drug to be advised specifically for PAD.

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton locum chambers, and Pallant Medical Chambers Clinical Guidelines Lead Partner.

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