Component

Details

Risk factors

Diabetes, hypertension, hyperlipidaemia, family history of cardiovascular disease, sedentary life, tobacco, chronic kidney disease

Clinical assessment

Claudication relieved by rest; full lower-limb examination; pulses from abdominal aorta to foot; abdominal and pelvic bruits; handheld Doppler if pulses are absent

Ankle-brachial index

Ankle systolic BP ÷ brachial systolic BP: 0.9–1.1 normal; below 0.9 suggests PAD

Laboratory

Renal function, lipid profile

Imaging

Duplex ultrasound, CT angiography, MR angiography, conventional angiography (gold standard when intervention is planned)

Non-pharmacological

Stop smoking, regular exercise, control diabetes, hypertension and lipids

Medicines

A: Acetylsalicylic acid 75 mg PO every 24 hours OR D: clopidogrel 75 mg PO every 24 hours, AND/OR S: cilostazol 100 mg PO every 12 hours

Surgery / intervention

For severe disease, critical limb ischaemia or lifestyle-limiting claudication despite medicines: bypass surgery, endovascular therapy (stent, balloon angioplasty, atherectomy), thrombectomy, catheter-directed thrombolysis