Comments regarding ‘Prevalence and Predictors of Persistent Health Status Impairment in Patients Referred to a Vascular Clinic with Intermittent Claudication’

Abstract

As the risk of major amputation is exceedingly small for patients with intermittent claudication, management, besides cardiovascular risk reduction, aims essentially at symptomatic relief and improved quality of life. Treatment efficacy has traditionally been assessed using walking distances. Patient-related factors associated with failure to improve quality of life, however, have largely been ignored. In this issue of the European Journal of Vascular and Endovascular Surgery, Safley et al. propose a set of such criteria to identify a vulnerable subset of patients with intermittent claudication in which treatment failure is likely. The issue is important for several reasons. The burden of symptomatic peripheral arterial disease on quality of life is substantial and is in the same range as for other forms of arterial disease. In contrast to the coronary or the cerebrovascular territories, however, prognostic significance of peripheral arterial disease and its management are likely underestimated within primary care. Already a decade ago, the US PARTNERS programme reported a striking degree of negligence among primary care providers vis-a-vis suspicion and appropriate treatment of peripheral arterial disease.