Peripheral arterial disease
Patient education and follow-up
Counsel patients about the natural progression of PAD, and reassure them that systemic atherosclerosis can be significantly stabilized if patients comply with risk factor and medical therapy. Most PAD will not progress to a point requiring an intervention, and modification of risky behaviors—including smoking, exercise and diet—can greatly reduce the disease’s progression.
Recommend periodic follow-up to evaluate medical control of hypertension, lipids, diet and tobacco use. Regularly check blood pressure, lipid levels, creatinine and fasting blood glucose in this high risk population.
Patients who undergo surgical arterial reconstruction will need lifelong follow-up by physical exam, ABI, and duplex ultrasound bypass graft interrogation. Postsurgical graft stenosis is the leading cause of long-term graft failures. Detecting subclinical graft stenosis can allow intervention before graft thrombosis occurs. Bypass salvage is usually unsuccessful after thrombosis, and thromboytics are often not efficacious.
|
Patients who undergo surgical arterial reconstruction will need lifelong follow-up. |
Little data exist regarding follow-up for patients who have had an endovascular revascularization, though routine follow up for recurrent PAD symptoms is indicated at 6 months to yearly intervals.
Wound care after an intervention depends on the severity of the wound, complications and the patient’s support systems. Wounds and complications are common after peripheral surgical interventions, and wound healing may take weeks to months and require further surgeries.
Internist Archives Quick Links
ACP Career Connection
Looking for a new internal medicine or subspecialty position?
ACP Career Connection can help you find your next job in internal medicine. Search internist and subspecialist positions nationwide that suit your criteria and preferences. Jobs are posted about two weeks before print publication of Annals of Internal Medicine, ACP Internist, and ACP Hospitalist. Exclusive “Online Direct” opportunities are updated weekly. Check us out online.
New ACP Online Clinical Information Page
Sneak a peek at ACPs new and improved Clinical Information page! Test drive the beta version of our redesigned Clinical Information landing page, give us your feedback, and help us make it as easy to use as possible.
Your Opinion Counts
Twice a year, ACP participates in a journal readership survey of random internists. If you receive one of these surveys in the mail, please indicate if you read our journals and answer the questions about your reading habits of our journals.
Your voice in these surveys is very important to ACP and enables us to continue to produce the high-quality publications that you expect. Find out more.