How to approach a patient with peripheral arterial disease

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Peripheral Arterial Disease (PAD) is defined as chronic atherosclerotic disease of the lower limbs. Patients with lower extremity PAD present with wide spectrum of symptoms ranging from asymptomatic to minor exertoinal leg pain, significant walking impairment and ulceration or gangrene. The first step in decision making for the treatment of PAD is to confirm PAD with history, physical examination and non invasive vascular laboratory tests. Decision making regarding revascularization is based on symptom status and patient comorbidities. Treatment strategies for intermittent claudication is medical management and for critical limb ischemia is revascularization in the form of either endovascular or surgical management to avoid amputation.