Peripheral Arterial Disease: Assessment Techniques

PAD Morbidity and Mortality

Did you know that peripheral arterial disease (PAD) is asymptomatic in 50-75% of cases(1)?  This is an alarming statistic, especially when we consider that PAD is a strong risk factor for cardiovascular disease (the leading cause of death worldwide).

Considering also that 25% of cases of sudden cardiac death have no prior symptoms or appreciable risk factors(2), the need for early detection of PAD becomes clear.

As well as its link to mortality, PAD is a leading cause of morbidity - PAD can lead to foot ulceration, which can lead to amputation - with devastating physical and emotional impacts on the individual as well as significant financial implications for the health system.

Currently, PAD is underdiagnosed, hence undertreated(3). There is a compelling need for more targeted screening in at-risk populations to reduce morbidity and mortality rates in people with PAD. 

Barriers to screening

One of the reasons for underdiagnosis is inadequate screening due to a lack of knowledge among Health Professionals of which assessments are most effective in making a diagnosis of PAD. Commonly used tests for PAD have limited sensitivity in the most at-risk populations (4). Clinical assessments range from simple observation to more complex ABI (ankle-brachial index). Research supports the use of some, but not all of these assessment techniques. Below are some of the most common:

• Palpation of pedal pulses
• Buerger’s sign
• Capillary filling time
• Simple doppler ultrasound
• ABI
• Toe pressures

Another barrier to effective screening is that certain guidelines don’t reflect the latest evidence.

With all this in mind, I’m sure you’re keen to learn more.  Join us on Monday, August 6th at 7.30PM (AEST) for a one-hour webinar, where our expert presenter Dr Sylvia McAra will share a best-practice approach to assessing PAD using evidence-based clinical tests.

This is a multidisciplinary webinar for Podiatrist, GPs and Nurses. Click here to read more and enrol.

References:

1. Diehm et al, 2009
2. Greenland et al, 2001
3. Lange et al, 2004
4. McAra et al, 2017