A clinical staging system for panvascular disease

The development of panvascular disease (PVD) is classified into four stages: the panvascular risk factor stage, subclinical PVD stage, monovascular disease stage, and polyvascular disease stage. This staging system offers a comprehensive framework for the precise management of the disease. Panvascular diseases (PVDs) are a group of systemic vascular disorders that share a common pathological characteristic—atherosclerosis, primarily manifesting as coronary heart disease, cerebrovascular disease, and peripheral artery disease 1. Unlike traditional atherosclerotic cardiovascular disease paradigms that focus on discrete vascular events such as myocardial infarction or ischemic stroke, PVD recognizes the interconnected nature and cumulative burden of atherosclerotic lesions across diverse vascular beds. In 2022, there were more than 0.5 billion cases of clinical PVD. Although significant advances have been made in the prevention and treatment of PVD, it remains a major cause of morbidity and mortality worldwide 2. Owing to the similar underlying pathological mechanisms among different PVD subtypes, these subtypes share overlapping risk factors and management approaches. Nonetheless, the management of PVD is often fragmented, with different medical specialties handling distinct aspects of the disease. This siloed approach, where specialists focus primarily on local lesions, frequently overlooks the broader, systemic vascular damage that characterizes PVD, probably leading to poor patient experience, increased healthcare costs, and a decline in medical efficiency and effectiveness. Therefore, integrated management strategies for PVD are essential to decrease the global health burden more efficiently 3.