Update information: This guideline was updated by a NICE standing committee in February 2018 and 2 new recommendations were added on diagnosing peripheral arterial disease in people with diabetes. The recommendations are in section 1.3 of the guidance. The evidence for these recommendations is in evidence reviews A: determining the diagnosis and severity of peripheral arterial disease in people with diabetes. December 2020: NICE added links in the recommendation on pain relief to other NICE guidelines and resources that support discussion with patients about opioid prescribing and safe withdrawal management. For the current recommendations, see www.nice.org.uk/guidance/CG147/chapter/recommendations. October 2018: The antiplatelet therapy link in recommendation 1.2.1 was updated.
Lower Limb Peripheral Arterial Disease
NICE Clinical Guidelines, No. 147
Authors
National Clinical Guideline Centre (UK).Excerpt
Lower limb peripheral arterial disease (known in the document as peripheral arterial disease, PAD) is a marker for an increased risk of potentially preventable cardiovascular events even when it is asymptomatic. If it becomes symptomatic it can lead to significant impairment of quality of life through limiting mobility and in its more severe manifestations may lead to severe pain, ulceration and gangrene and is the largest single cause of lower limb amputation in the UK.
The management of PAD of the lower limb remains controversial and treatments range from watchful waiting, through medical management, exercise training, endovascular treatment or surgical reconstruction. Rapid changes in diagnostic methods, endovascular treatments and vascular services, associated with the emergence of new subspecialities in surgery and vascular radiology, has resulted in considerable uncertainty and variation in practice. This guideline aims to resolve that uncertainty and variation.
Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.
The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.
The rights of National Clinical Guideline Centre to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.