[Intermittent claudication and critical limb ischemia : from diagnosis to management]

Area of Science:

• Vascular Medicine
• Cardiovascular Surgery
• Interventional Radiology

Background:

• Atheromatous disease often presents with comorbidities, necessitating a multidisciplinary approach.
• Angiologic assessment is crucial for diagnosing peripheral artery disease (PAD), even in apparent cases.
• Patients are frequently fast-tracked to radiological investigations, potentially bypassing thorough angiologic evaluation.

Purpose of the Study:

• To emphasize the importance of multidisciplinary decision-making in atheromatous disease.
• To highlight the critical role of angiologic assessment in peripheral artery disease diagnosis.
• To outline the appropriate treatment pathways for peripheral artery disease based on disease severity.

Main Methods:

• Review of current clinical guidelines and best practices for PAD management.
• Analysis of diagnostic pathways, comparing angiologic assessment with radiological investigations.
• Evaluation of treatment strategies, including medical management and revascularization.

Main Results:

• Multidisciplinary input is vital due to associated comorbidities in atheromatous disease.
• Angiologic assessment remains paramount for accurate PAD diagnosis, despite the speed of radiological methods.
• Medical treatment is the primary approach for all PAD stages, except for critical limb ischemia.

Conclusions:

• Integrated, multidisciplinary care is essential for managing patients with atheromatous disease.
• Timely and accurate angiologic assessment should guide PAD diagnosis and treatment planning.
• Revascularization is indicated for critical limb ischemia or refractory lifestyle-limiting symptoms after medical treatment failure.