[Update ESC-Guideline 2017: Focus on PAD]. / Update ESC-Leitlinie 2017: Periphere arterielle Verschlusserkrankung.
Dtsch Med Wochenschr
; 143(20): 1455-1459, 2018 10.
Article
em De
| MEDLINE
| ID: mdl-30286494
ABSTRACT
The updated ESC guidelines on PADâwere developed, for the first time, as a collaboration between cardiologists and vascular surgeons and unveiled at the European Society of Cardiology (ESC) 2017 congress. Although awareness has improved, PADâis still associated with significant morbidity, mortality, and quality of life impairment. Primarily, the guidelines emphasize the need for a multidisciplinary management of these patients and propose "a vascular team". A new chapter on antithrombotic therapies is provided. In patients with symptomatic peripheral artery disease, clopidogrel can be considered over aspirin therapy (class IIb). Antiplatelet therapy is no longer recommended in asymptomatic peripheral artery disease patients (class III). After peripheral arterial intervention, dual antiplatelet therapy is recommended as a consensus. Moreover, all patients with lower extremity artery disease should be treated with statins to improve walking distance (class I) as well as supervised exercise therapy, even after revascularization. In claudicants, cardiovascular prevention and exercise training remain the cornerstones of management. The WIFI classification (risk stratification based on wound ischemia and foot infection) is proposed to primarily describe wound lesions. Regarding surgical or interventional therapies, the new guidelines propose an endovascular approach for short lesions (<â5âcm) in the aortoiliac or aortobifemoral region. Patients with infrapopliteal lesions should be treated with bypass surgery or endovascular therapy. Patients with coronary artery disease or heart failure should be considered for lower extremity peripheral artery disease screening (class IIb).
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1
Base de dados:
MEDLINE
Assunto principal:
Guias de Prática Clínica como Assunto
/
Doença Arterial Periférica
Tipo de estudo:
Guideline
Limite:
Humans
Idioma:
De
Revista:
Dtsch Med Wochenschr
Ano de publicação:
2018
Tipo de documento:
Article