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2014 ; 31
(4
): 292-9
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Clinical assessment of patients with peripheral arterial disease
#MMPMID25435653
Bailey MA
; Griffin KJ
; Scott DJ
Semin Intervent Radiol
2014[Dec]; 31
(4
): 292-9
PMID25435653
show ga
Peripheral arterial disease (PAD) describes the clinical manifestations of
atherosclerosis affecting the circulation in the legs. The severity of PAD is
classified according to symptom severity, time course, and anatomical
distribution. The signs and symptoms of PAD reflect the degree of circulatory
compromise and whether there has been a gradual reduction in the circulation or
an abrupt, uncompensated decrease. Accurate clinical assessment underpins
decisions on management strategy and should objectively assess the severity of
the ischemia and need for revascularization. Clinical history should discriminate
symptoms of PAD from other conditions presenting with leg pain, elucidate
cardiovascular risk factors and the effect of symptoms on the patient's quality
of life. Clinical examination includes signs of general cardiovascular disease
and associated conditions before assessing the circulation and viability of the
limb. Palpation of peripheral pulses must be augmented by determination of the
ankle brachial pressure index using hand held Doppler. A whole patient approach
to management is required and must include modification of cardiovascular risk
status as well as dealing with the local circulatory manifestation of PAD.