American College of Physicians: Internal Medicine — Doctors for Adults ®


Peripheral arterial disease

Prevention and Screening




Management consultation


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.


This is a printer-friendly version of this page

Print this page  |  Close the preview




Internist Archives Quick Links

Annals Virtual Patients Series 1-4 Available

Annals Virtual Patient series 1-4 available

Annals Virtual Patients is a unique online patient simulator that helps you learn while you earn CME Credit and MOC Points.
Start your journey now.


ACP keeps you on target to earn MOC Points

ACP keeps you on target to earn MOC Points

December 2015 is the deadline for most internists participating in ABIM MOC to earn some MOC points. Review our stimulating and rewarding options.