Peripheral artery disease is under diagnosed and often inadequately treated. Multidisciplinary collaboration improves decision making, ensures thorough evaluation and management of global atherosclerosis, and optimizes short- and long-term outcomes.
Patients who are 70 or older, are diabetic and smoke or have other vascular symptoms may also have asymptomatic peripheral artery disease (PAD). Examination of legs and feet, a pulse exam and an ankle-brachial index may lead to a diagnosis.
Claudication is sometimes the first sign that an individual has cardiovascular disease (CVD), on top of their peripheral artery disease (PAD). Patients with both conditions need to be closely followed by vascular specialists and cardiologists.
A 57-year-old man referred to UCSF for transplant evaluation was quickly found to have extensive ischemic heart disease, in addition to kidney disease and claudication in both legs. Teamwork carried out aggressive treatment for volume removal, atherectomy and angioplasty, and finally femoral-popliteal artery bypass with a saphenous vein graft. The motivated patient became a candidate for a combined heart and kidney transplant.
Treatment of the most severe stage of PAD — critical limb ischemia — should be multifaceted and include medication and lifestyle modifications.
With early diagnosis and close monitoring, diabetic patients with PAD can fare as well as nondiabetic patients.
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The UCSF Transfer Center is open 24 hours daily to coordinate the transfer of your patients to UCSF Medical Center from hospitals throughout the region.
Phone: (415) 353-9166
Fax: (415) 353-9172