Draft guidance has been published by the National Institute for Health and Clinical Excellence (NICE) to reduce “considerable uncertainty and variations in practice” in the treatment of peripheral arterial disease (PAD).
It is the biggest cause of lower limb amputation in the UK and is most common among smokers and patients with diabetes or coronary artery disease.
Treatment options depend on the level of severity and range from changes in lifestyle, advice to exercise, management of cardiovascular risk factors and vasoactive drug treatment such as naftidrofuryl, to endovascular treatments and surgical reconstruction to unblock or bypass occluded or narrowed arteries.
However, Christine Carson, programme director at NICE’s centre for clinical practice, said the management of peripheral arterial disease remained “controversial”.
“Although effective treatments are available that can improve symptoms and stop disease progression, rapid changes in diagnostic methods, the emergence of new endovascular treatments and organisational changes in the provision of vascular services have resulted in considerable uncertainty and variations in practice across the UK,” she said.
“This draft guideline aims to improve outcomes for patients by clarifying what tests and treatments provide the most clinically and cost effective PAD diagnostic and treatment pathways.”
The document - ‘Lower limb peripheral arterial disease’ - is open to consultation until 24 April.