MBBS (Hons), FRACS (Vascular), Consultant Vascular Surgeon and Senior Lecturer, University of Sydney; Faculty of Medicine and Health, Concord Clinical School, NSW; Co-Chair, Concord Institute of Academic Surgery, NSW; Consultant Vascular Surgeon, Concord Repatriation General Hospital, NSW; Research Affiliate, Centre for Education and Research on Ageing, NSW.
Aust J Gen Pract. 2020 May;49(5):239-244. doi: 10.31128/AJGP-11-19-5160.
Patients with lower limb peripheral artery disease (PAD) are at high risk of cardiovascular mortality and morbidity along with limb loss. PAD is underdiagnosed in the community and presents a missed opportunity to prescribe evidence-based secondary prevention therapy.
The aim of this article is to summarise key updates in the management of patients with PAD, with particular reference to newly published guidelines.
PAD continues to be a major contributor to the mortality and morbidity of patients with atherosclerosis in Australia. For patients with chronic limb-threatening ischaemia, revascularisation remains the mainstay of limb salvage, and expedited access to vascular surgery assessment is necessary. Both prescription of, and adherence to, evidence-based secondary prevention therapy is low. A greater emphasis on cardiovascular risk factor modification for all patients with PAD is required to improve long-term outcomes. General practitioners and vascular surgeons can work collaboratively to provide patient-centred, effective care to patients with PAD.
下肢外周动脉疾病（PAD）患者心血管死亡率和发病率高，同时存在肢体丧失的风险。PAD 在社区中诊断不足，这是一个错过开具循证二级预防治疗的机会。
本文旨在总结 PAD 患者管理方面的重要更新，特别参考新发表的指南。
PAD 仍然是澳大利亚动脉粥样硬化患者死亡率和发病率的主要原因。对于慢性肢体威胁性缺血的患者，血运重建仍然是肢体挽救的主要方法，需要加快血管外科评估的速度。循证二级预防治疗的开具和遵守率都很低。需要更加重视所有 PAD 患者的心血管危险因素的改变，以改善长期预后。全科医生和血管外科医生可以合作，为 PAD 患者提供以患者为中心的有效护理。
