REVIEW   

Italian Journal of Vascular and Endovascular Surgery 2019 September;26(3):140-50

DOI: 10.23736/S1824-4777.19.01418-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Saving lives, saving limbs: tackling the global pandemic of peripheral arterial disease

Daniel URRIZA RODRIGUEZ ¹, Dominic P. HOWARD ^{1, 2} ✉

¹ Department of Vascular Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; ² Nuffield Department of Surgical Sciences (NDS) and Clinical Neurosciences (NDCN), University of Oxford, Oxford, UK

Peripheral arterial disease (PAD) is a major global health issue with over 200 million people currently affected by PAD. This number is expected to rise with the predicted increase in incidence of diabetes mellitus and the ever-ageing population. PAD has been neglected in terms of research and preventative strategies, which has resulted in an excessive number of major lower limb amputations. The objectives of the review are to examine preventative strategies available in PAD and explore the financial impact of both PAD and interventions on the healthcare economy. The review will also consider future developments and discuss changes that may affect future practice. Clinically and cost-effective preventative strategies exist but more needs to be done to fully implement them. The key measure is to reduce pre-morbid cardiovascular disease risk factors in patients with PAD before they develop advanced disease, acute or critical limb ischemia. For these to be possible, close working relationships are needed between community and secondary care teams. Vascular networks must provide rapid access, diagnosis and treatment in limb revascularization. Multi-disciplinary team working must be a key cornerstone of any vascular service that wants to care for patients with PAD. More needs to be done to improve and encourage research into PAD. Research should focus on population-based preventative strategies and the development of systems and pathways to improve outcomes.

KEY WORDS: Peripheral arterial disease; Prevention and control; Cost-benefit analysis