Peripheral vascular disease
Lower limb peripheral arterial disease from claudication to chronic limb-threatening and acute limb ischaemia, with ABI interpretation, risk factor treatment, antithrombotic choices (COMPASS, VOYAGER-PAD) and when to revascularise.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Peripheral arterial disease (PAD) here means atherosclerotic narrowing of the lower limb arteries. Carotid and renal disease are covered in ischaemic stroke and hypertension; aneurysms in aortopathy.
- PAD is a marker of systemic atherosclerosis. Most patients die of MI or stroke, not of their legs. Treat it as a coronary risk equivalent.
- Most patients are asymptomatic or have atypical leg symptoms. Only about 1 in 10 has classic claudication.
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Sources
- Mazzolai L, Teixido-Tura G, Lanzi S et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J 2024;45:3538-700European Society of Cardiology, 2024
- Gornik HL, Aronow HD, Goodney PP et al. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease. Circulation 2024;149:e1313-e1410American College of Cardiology and American Heart Association, 2024
- Therapeutic Guidelines: Cardiovascular. Peripheral arterial diseaseAU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition (version not verified)
- Australian evidence-based guidelines for diabetes-related foot diseaseAU/NZDiabetes Feet Australia (Australian Diabetes Society and partners), 2021
- Rivaroxaban 2.5 mg (Xarelto) for chronic stable atherosclerotic disease: PBS listing, 1 December 2020AU/NZPharmaceutical Benefits Scheme, 2020
- Bonaca MP, Bauersachs RM, Anand SS et al. Rivaroxaban in peripheral artery disease after revascularization (VOYAGER PAD). N Engl J Med 2020;382:1994-2004New England Journal of Medicine, 2020
- Farber A, Menard MT, Conte MS et al. Surgery or endovascular therapy for chronic limb-threatening ischemia (BEST-CLI). N Engl J Med 2022;387:2305-16New England Journal of Medicine, 2022
- Bradbury AW, Moakes CA, Popplewell M et al. A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2). Lancet 2023;401:1798-809The Lancet, 2023
- Bonaca MP, Catarig AM, Houlind K et al. Semaglutide and walking capacity in people with symptomatic peripheral artery disease and type 2 diabetes (STRIDE). Lancet 2025;405:1580-93. doi:10.1016/S0140-6736(25)00509-4The Lancet, 2025
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy