Peripheral artery disease
Also known as: claudication · PAD · peripheral vascular disease · PVD
Free to read — no account needed. Sign in only to bookmark this disease and track your study progress.
2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease
ACC/AHA and multisociety (AACVPR, APMA, ABC, SCAI, SVM, SVN, SVS, SIR, VESS) · 2024
This is the current US guideline for lower extremity peripheral artery disease, developed across eleven professional organisations. It organises guidance around four clinical presentation subsets — asymptomatic disease, chronic symptomatic PAD, chronic limb-threatening ischaemia and acute limb ischaemia — and covers diagnosis, medical therapy, revascularisation, multidisciplinary care and health disparities. Metadata record only.
- Published in Circulation on 14 May 2024 under the ACC/AHA Joint Committee with ten additional collaborating societies. source
- Structures recommendations around asymptomatic PAD, chronic symptomatic PAD, chronic limb-threatening ischaemia and acute limb ischaemia. source
- Emphasises early diagnosis and treatment to improve outcomes and reduce amputation risk, and addresses multidisciplinary care and health disparities. source
2024 ESC Guidelines for the management of peripheral arterial and aortic diseases
European Society of Cardiology (ESC), endorsed by EACTS, VASCERN and ESVM · 2024
The 2024 ESC guideline is the current European reference for peripheral arterial disease, including lower extremity disease. It merges peripheral arterial and aortic disease into one document on the reasoning that these territories share a disease process and that patients with one are at risk of the other. Coverage runs from diagnosis and risk stratification at presentation through revascularisation to long-term post-hospitalisation management and prevention. Metadata record only.
- Published in the European Heart Journal in August 2024; updates and replaces the 2017 ESC peripheral arterial diseases guideline. source
- First ESC document to combine peripheral arterial and aortic disease recommendations, reflecting shared risk across the arterial system. source
- Aimed at cardiologists, aligned with EACTS surgical guidance, and endorsed by VASCERN and the European Society of Vascular Medicine. source
US vs EU key differences
- The 2024 ESC guideline sets an explicit numeric lipid goal for atherosclerotic PAD — LDL-C below 55 mg/dL together with a reduction of more than 50% from baseline (Class I, Level A) — tightened from the previous under-70 mg/dL threshold. source
- The 2024 US PAD guideline instead anchors on intensity rather than an absolute target, recommending high-intensity statin for all PAD patients (Class 1, Level A) aiming at a 50% or greater LDL-C reduction, adding ezetimibe or a PCSK9 inhibitor when that is not achieved. source
- Document scope differs: the European guideline merges peripheral arterial and aortic disease into one 2024 text (replacing the 2017 PAD and 2014 aortic guidelines), whereas the US keeps lower-extremity PAD and aortic disease as separate guidelines. source
- The US guideline is distinctive in formalising non-clinical risk, asking clinicians to weigh 'PAD risk amplifiers' such as race, ethnicity, social determinants of health and polyvascular disease, and in organising care around four clinical subsets (asymptomatic, chronic symptomatic, chronic limb-threatening ischaemia, acute limb ischaemia). source
What changed recently
- EU2017 → 20242024-08-30
Replacing the 2017 ESC peripheral arterial diseases guideline and merging it with aortic disease guidance, the 2024 document keeps single antiplatelet therapy as the Class I default in symptomatic peripheral artery disease but adds dual pathway inhibition with low-dose rivaroxaban plus aspirin for patients at high ischaemic and low bleeding risk, including after lower-limb revascularisation.
source ↗curation confidence 90% - US2016 → 20242024-05-14
The 2024 multisociety guideline updates the 2016 AHA/ACC lower extremity peripheral artery disease guideline and reorganises care around four clinical presentations - asymptomatic disease, chronic symptomatic disease, chronic limb-threatening ischaemia and acute limb ischaemia. It adds recommendations on identifying PAD risk amplifiers and health disparities and on structured medical and lifestyle therapy within a team-based care plan.
source ↗curation confidence 90%
See the full update feed for changes across every system.