[ESC guidelines 2017 on peripheral arterial diseases : Summary of the most important recommendations and innovations].

Abstract

The current European Society of Cardiology (ESC) guidelines on peripheral arterial diseases include recommendations on diagnostics and treatment of atherosclerotic manifestations in peripheral arteries. Because of the high coincidence of atherosclerosis in different arterial territories, screening for other atherosclerotic lesions is necessary in patients with clinical symptoms in one vascular bed. Consistent treatment of cardiovascular risk factors is important in all patients with peripheral atherosclerosis. This includes smoking cessation, statin therapy and control of blood pressure and blood glucose. All patients with carotid artery stenosis should be treated with antiplatelet drugs. In patients with symptomatic carotid artery stenosis and low periprocedural risk, early revascularization is recommended when the degree of stenosis is more than 50%. In asymptomatic carotid artery stenosis revascularization should only be considered if the risk for cerebral embolization is high and the periprocedural risk is low. Patients with peripheral arterial occlusive disease should only be treated with an antiplatelet drug if they are symptomatic. In cases of intermittent claudication supervised exercise training is strongly recommended. When activities of daily life are compromised despite training, revascularization by endovascular therapy first should be considered. In chronic limb-threatening ischemia early revascularization should be considered, preferably by venous bypass surgery. In patients with arterial hypertension and specific risk factors screening for renal artery stenosis is recommended. Particularly in patients with atherosclerotic renal artery stenosis, the indications for revascularization should be assessed very carefully.

• Authors: C Espinola-Klein
• Journal: Herz (Herz) Vol. 42 Issue 8 Pg. 721-727 (Dec 2017) ISSN: 1615-6692 [Electronic] Germany
• Vernacular Title: ESC-Leitlinien 2017 „Peripheral Arterial Diseases“ : Zusammenfassung der wichtigsten Empfehlungen und Neuerungen.
• PMID: 29143147 (Publication Type: Journal Article, Practice Guideline, Review)

Chemical References

• Blood Glucose
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Platelet Aggregation Inhibitors

Topics

• Blood Glucose (metabolism)
• Blood Pressure
• Carotid Stenosis (diagnosis, etiology, therapy)
• Combined Modality Therapy
• Exercise Therapy
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Peripheral Arterial Disease (diagnosis, etiology, therapy)
• Platelet Aggregation Inhibitors (therapeutic use)
• Smoking Cessation
• Vascular Surgical Procedures