Diagnosis and management of peripheral arterial disease

#### Summary points Peripheral arterial disease (PAD) is an atherosclerotic process that causes stenosis and occlusion of non-cerebral and non-coronary arteries. It has an estimated worldwide prevalence of almost 10%, rising to 15-20% in people over 70 years of age, 1 2 and it affects around 27 million people in Europe and North America alone. 3 Critical limb ischaemia—the most severe manifestation of the disease—can lead to limb loss or even death if not treated promptly. Each year, 500-1000 new cases of critical limb ischaemia are diagnosed per million of the population, with an estimated annual cost to the NHS of more than £200m (€255m; 314m). 4 #### Sources and selection criteria We searched Medline, Embase, and the Cochrane Database for systematic reviews and meta-analyses related to the diagnosis and management of peripheral arterial disease. We also consulted relevant national and international guidelines published by the National Institute for Health and Clinical Excellence, the Trans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease, and the International Working Group on the Diabetic Foot. Increased awareness of the disease, enhanced medical treatment, and new endovascular interventions have dramatically improved the management of patients with PAD. 5 6 With the publication of new National Institute for Health and Clinical Excellence (NICE) guidelines on the management of this disease, this review offers a timely summary of current evidence relating to PAD and provides …