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<meta name="robots" content="NOINDEX,NOFOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="author" content="National Clinical Guideline Centre (UK)" /><meta name="citation_title" content="Lower Limb Peripheral Arterial Disease" /><meta name="citation_publisher" content="Royal College of Physicians (UK)" /><meta name="citation_date" content="2012/08" /><meta name="citation_author" content="National Clinical Guideline Centre (UK)" /><meta name="citation_pmid" content="26065061" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK299071/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Lower Limb Peripheral Arterial Disease" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="Royal College of Physicians (UK)" /><meta name="DC.Contributor" content="National Clinical Guideline Centre (UK)" /><meta name="DC.Date" content="2012/08" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK299071/" /><meta name="description" content="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." /><meta name="og:title" content="Lower Limb Peripheral Arterial Disease" /><meta name="og:type" content="book" /><meta name="og:description" content="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." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK299071/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg147-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="warning" content="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." /><meta name="bk-non-canon-loc" content="/books/n/nicecg147/toc/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK299071/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">.main-content {background:transparent repeat-y top left;background-image:url(/corehtml/pmc/css/bookshelf/2.26/img/partially_updated.png);background-size: auto, contain; padding:0 0 0 3em }</style><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} </style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="nicecollect" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div><div class="bk_msg_box bk_bttm_mrgn clearfix bk_noprnt"><div class="iconblock clearfix"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/nicecg147guid/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg147guid-lrg.png" alt="Cover" height="100px" width="80px" /></a><div class="icnblk_cntnt"><ul class="messages"><li class="info icon"><span class="icon"><a href="/books/n/nicecg147guid/">See 2020 Partial Update</a></span></li></ul></div></div></div><div class="messagearea bk_noprnt" style="margin-bottom:1.3846em "><ul class="messages"><li class="warn icon"><span class="icon">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.</span></li></ul></div><div class="bk_prnt"><p style="color:red;"><strong>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.</strong></p></div><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nicecg147/fm.s1/" title="Next page in this title">Next ></a></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://www.rcplondon.ac.uk/Pages/index.aspx" title="Royal College of Physicians (UK)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg147-lrg.png" alt="Cover of Lower Limb Peripheral Arterial Disease" /></a><div class="icnblk_cntnt"><h1 id="_NBK299071_"><span itemprop="name">Lower Limb Peripheral Arterial Disease</span></h1><div class="subtitle">Diagnosis and Management</div><p><i>NICE Clinical Guidelines, No. 147</i></p><p class="contrib-group"><span itemprop="author">National Clinical Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="http://www.rcplondon.ac.uk/Pages/index.aspx" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">Royal College of Physicians (UK)</span></a>; <span itemprop="datePublished">2012 Aug</span>.</div><div class="half_rhythm"><ul class="inline_list"><li><span class="label"><a data-jig="ncbidialog" href="#_ncbi_dlg_cpyrght_NBK299071" data-jigconfig="modal:true">Copyright and
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</div></div></div></div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Excerpt</h2><p>
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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.</p><p>
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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.</p></div><div><h2>Contents</h2><div class="bktoc_all_cntnr top align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div><ul id="toc_tllNBK299071_toc_fm_s1" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK299071_toc_fm_s1"><a class="toc-item" href="/books/n/nicecg147/fm.s1/">Guideline development group members</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_fm_ack"><a class="toc-item" href="/books/n/nicecg147/fm.ack/">Acknowledgments</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_fm_s6"><a class="toc-item" href="/books/n/nicecg147/fm.s6/">Abbreviations</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch1"><a class="toc-item" href="/books/n/nicecg147/ch1/">1. Introduction</a><ul id="toc_lst_NBK299071_toc_ch1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch1_s1"><a class="toc-item" href="/books/n/nicecg147/ch1/#ch1.s1">1.1. Background and incidence</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch1_s2"><a class="toc-item" href="/books/n/nicecg147/ch1/#ch1.s2">1.2. Specific risk factors</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch1_s3"><a class="toc-item" href="/books/n/nicecg147/ch1/#ch1.s3">1.3. Definitions and classification systems</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch1_s10"><a class="toc-item" href="/books/n/nicecg147/ch1/#ch1.s10">1.4. Initial management</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch1_s11"><a class="toc-item" href="/books/n/nicecg147/ch1/#ch1.s11">1.5. Secondary care</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch1_s12"><a class="toc-item" href="/books/n/nicecg147/ch1/#ch1.s12">1.6. Importance to the NHS</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch2"><a class="toc-item" href="/books/n/nicecg147/ch2/">2. Development of the guideline</a><ul id="toc_lst_NBK299071_toc_ch2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch2_s1"><a class="toc-item" href="/books/n/nicecg147/ch2/#ch2.s1">2.1. What is a NICE clinical guideline?</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch2_s2"><a class="toc-item" href="/books/n/nicecg147/ch2/#ch2.s2">2.2. Remit</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch2_s3"><a class="toc-item" href="/books/n/nicecg147/ch2/#ch2.s3">2.3. Who developed this guideline?</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch2_s4"><a class="toc-item" href="/books/n/nicecg147/ch2/#ch2.s4">2.4. What this guideline covers</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch2_s5"><a class="toc-item" href="/books/n/nicecg147/ch2/#ch2.s5">2.5. What this guideline does not cover</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch2_s6"><a class="toc-item" href="/books/n/nicecg147/ch2/#ch2.s6">2.6. Relationships between the guideline and other NICE guidance</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch3"><a class="toc-item" href="/books/n/nicecg147/ch3/">3. Methods</a><ul id="toc_lst_NBK299071_toc_ch3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch3_s1"><a class="toc-item" href="/books/n/nicecg147/ch3/#ch3.s1">3.1. Developing the review questions and outcomes</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch3_s5"><a class="toc-item" href="/books/n/nicecg147/ch3/#ch3.s5">3.2. Searching for evidence</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch3_s9"><a class="toc-item" href="/books/n/nicecg147/ch3/#ch3.s9">3.3. Evidence of effectiveness</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch3_s22"><a class="toc-item" href="/books/n/nicecg147/ch3/#ch3.s22">3.4. Evidence of cost-effectiveness</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch3_s29"><a class="toc-item" href="/books/n/nicecg147/ch3/#ch3.s29">3.5. Developing recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch4"><a class="toc-item" href="/books/n/nicecg147/ch4/">4. Guideline summary</a><ul id="toc_lst_NBK299071_toc_ch4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch4_s1"><a class="toc-item" href="/books/n/nicecg147/ch4/#ch4.s1">4.1. Key priorities for implementation</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch4_s9"><a class="toc-item" href="/books/n/nicecg147/ch4/#ch4.s9">4.2. Full list of recommendations</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch4_s23"><a class="toc-item" href="/books/n/nicecg147/ch4/#ch4.s23">4.3. Key research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch5"><a class="toc-item" href="/books/n/nicecg147/ch5/">5. Information requirements for people with peripheral arterial disease</a><ul id="toc_lst_NBK299071_toc_ch5" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch5_s1"><a class="toc-item" href="/books/n/nicecg147/ch5/#ch5.s1">5.1. Introduction</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch6"><a class="toc-item" href="/books/n/nicecg147/ch6/">6. Secondary prevention of cardiovascular disease in people with peripheral arterial disease</a><ul id="toc_lst_NBK299071_toc_ch6" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch6_s1"><a class="toc-item" href="/books/n/nicecg147/ch6/#ch6.s1">6.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch6_s10"><a class="toc-item" href="/books/n/nicecg147/ch6/#ch6.s10">6.2. Recommendation</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch7"><a class="toc-item" href="/books/n/nicecg147/ch7/">7. Diagnosis of peripheral arterial disease</a><ul id="toc_lst_NBK299071_toc_ch7" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch7_s1"><a class="toc-item" href="/books/n/nicecg147/ch7/#ch7.s1">7.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch7_s2"><a class="toc-item" href="/books/n/nicecg147/ch7/#ch7.s2">7.2. Methods of diagnosis of peripheral arterial disease</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch7_s14"><a class="toc-item" href="/books/n/nicecg147/ch7/#ch7.s14">7.3. Measuring the ankle brachial pressure index</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch8"><a class="toc-item" href="/books/n/nicecg147/ch8/">8. Imaging for revascularisation in peripheral arterial disease</a><ul id="toc_lst_NBK299071_toc_ch8" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch8_s1"><a class="toc-item" href="/books/n/nicecg147/ch8/#ch8.s1">8.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch8_s2"><a class="toc-item" href="/books/n/nicecg147/ch8/#ch8.s2">8.2. Review question</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9"><a class="toc-item" href="/books/n/nicecg147/ch9/">9. Management of intermittent claudication</a><ul id="toc_lst_NBK299071_toc_ch9" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9_s1"><a class="toc-item" href="/books/n/nicecg147/ch9/#ch9.s1">9.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9_s9"><a class="toc-item" href="/books/n/nicecg147/ch9/#ch9.s9">9.2. Supervised exercise compared to unsupervised exercise</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9_s36"><a class="toc-item" href="/books/n/nicecg147/ch9/#ch9.s36">9.3. Naftidrofuryl oxalate</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9_s48"><a class="toc-item" href="/books/n/nicecg147/ch9/#ch9.s48">9.4. Comparisons between treatment options: exercise, best medical treatment, angioplasty and bypass surgery</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9_s108"><a class="toc-item" href="/books/n/nicecg147/ch9/#ch9.s108">9.5. Angioplasty with selective stent placement compared to angioplasty with primary stent placement</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9_s120"><a class="toc-item" href="/books/n/nicecg147/ch9/#ch9.s120">9.6. Bare metal compared to drug eluting stents</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch9_s130"><a class="toc-item" href="/books/n/nicecg147/ch9/#ch9.s130">9.7. Autologous vein compared to prosthetic bypass</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch10"><a class="toc-item" href="/books/n/nicecg147/ch10/">10. Management of critical limb ischaemia</a><ul id="toc_lst_NBK299071_toc_ch10" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch10_s1"><a class="toc-item" href="/books/n/nicecg147/ch10/#ch10.s1">10.1. Introduction: chapter overview</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch10_s2"><a class="toc-item" href="/books/n/nicecg147/ch10/#ch10.s2">10.2. Angioplasty compared to bypass surgery</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch10_s17"><a class="toc-item" href="/books/n/nicecg147/ch10/#ch10.s17">10.3. Angioplasty with selective stent placement compared with angioplasty with primary stent placement</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch10_s31"><a class="toc-item" href="/books/n/nicecg147/ch10/#ch10.s31">10.4. Bare metal compared to drug eluting stents</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch10_s42"><a class="toc-item" href="/books/n/nicecg147/ch10/#ch10.s42">10.5. Autologous vein compared to prosthetic bypass</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch11"><a class="toc-item" href="/books/n/nicecg147/ch11/">11. Management of ischaemic pain in critical limb ischaemia</a><ul id="toc_lst_NBK299071_toc_ch11" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch11_s1"><a class="toc-item" href="/books/n/nicecg147/ch11/#ch11.s1">11.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch11_s2"><a class="toc-item" href="/books/n/nicecg147/ch11/#ch11.s2">11.2. Management options for pain in critical limb ischaemia</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch12"><a class="toc-item" href="/books/n/nicecg147/ch12/">12. Major amputation for critical limb ischaemia</a><ul id="toc_lst_NBK299071_toc_ch12" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch12_s1"><a class="toc-item" href="/books/n/nicecg147/ch12/#ch12.s1">12.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_ch12_s2"><a class="toc-item" href="/books/n/nicecg147/ch12/#ch12.s2">12.2. Review question</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_glossary"><a class="toc-item" href="/books/n/nicecg147/glossary/">13. Glossary</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_references"><a class="toc-item" href="/books/n/nicecg147/references/">14. References</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appendixes_appgroup1"><a class="toc-item" href="/books/n/nicecg147/appendixes.appgroup1/">Appendices</a><ul id="toc_lst_NBK299071_toc_appendixes_appgroup1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK299071_toc_appa"><a class="toc-item" href="/books/n/nicecg147/appa/">Appendix A. Scope</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appb"><a class="toc-item" href="/books/n/nicecg147/appb/">Appendix B. Declarations of interest</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appc"><a class="toc-item" href="/books/n/nicecg147/appc/">Appendix C. Review protocols</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appd"><a class="toc-item" href="/books/n/nicecg147/appd/">Appendix D. Literature search strategies</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appe"><a class="toc-item" href="/books/n/nicecg147/appe/">Appendix E. Exclusion lists – clinical evidence</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appf"><a class="toc-item" href="/books/n/nicecg147/appf/">Appendix F. Exclusion lists – economic evidence</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appg"><a class="toc-item" href="/books/n/nicecg147/appg/">Appendix G. Clinical evidence - study selection flowcharts</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_apph"><a class="toc-item" href="/books/n/nicecg147/apph/">Appendix H. Clinical evidence tables</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appi"><a class="toc-item" href="/books/n/nicecg147/appi/">Appendix I. Economic evidence tables</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appj"><a class="toc-item" href="/books/n/nicecg147/appj/">Appendix J. Forest plots</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appk"><a class="toc-item" href="/books/n/nicecg147/appk/">Appendix K. Cost-effectiveness analysis: Supervised exercise compared to unsupervised exercise for the treatment of people with intermittent claudication</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appl"><a class="toc-item" href="/books/n/nicecg147/appl/">Appendix L. Cost-effectiveness analysis – Exercise compared to angioplasty for the treatment of intermittent claudication</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appm"><a class="toc-item" href="/books/n/nicecg147/appm/">Appendix M. Research recommendations</a></li><li class="half_rhythm" id="toc_itm_NBK299071_toc_appn"><a class="toc-item" href="/books/n/nicecg147/appn/">Appendix N. References</a></li></ul></li></ul><div class="bktoc_all_cntnr align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div></div></div></div>
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</p></div><div class="small"><span class="label">Bookshelf ID: NBK299071</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26065061" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26065061</a></span></div><div style="margin-top:2em" class="bk_noprnt"><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nicecg147/fm.s1/" title="Next page in this title">Next ></a></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK299071/?report=reader">PubReader</a></li><li><a href="/books/NBK299071/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK299071" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK299071" style="display:none" title="Cite this Page"><div class="bk_tt">National Clinical Guideline Centre (UK). Lower Limb Peripheral Arterial Disease: Diagnosis and Management [Internet]. London: Royal College of Physicians (UK); 2012 Aug. (NICE Clinical Guidelines, No. 147.)<span class="bk_cite_avail"></span></div></div></li><li><a href="/books/n/nicecg147/pdf/">PDF version of this title</a> (3.4M)</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Other titles in this collection</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/nicecollect/">
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National Institute for Health and Clinical Excellence: Guidance
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</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related NICE guidance and evidence</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/nicecg147er/">Peripheral Arterial Disease: Diagnosis and Management [A] Evidence review for determining diagnosis and severity of PAD in people with diabetes</a></li><li><a href="/books/n/nicecg147eud/">Lower limb peripheral arterial disease: Evidence Update November 2014: A summary of selected new evidence relevant to NICE clinical guideline 147 'Lower limb peripheral arterial disease: diagnosis and management' (2012)</a></li><li><a href="/books/n/nicecg147surv1/">Surveillance report 2017 - Peripheral arterial disease: diagnosis and management (2012) NICE guideline CG147</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/28876730" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Peripheral Arterial Disease – Diagnosis and Treatment: A Systematic Review</a><span class="source">[ 2008]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" 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xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Treatment Strategies for Patients With Peripheral Artery Disease<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Jones WS, Schmit KM, Vemulapalli S, Subherwal S, Patel MR, Hasselblad V, Heidenfelder BL, Chobot MM, Posey R, Wing L, et al. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">2013 May</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/32073808" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Peripheral arterial disease: diagnosis and management</a><span class="source">[ 2020]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Peripheral arterial disease: diagnosis and management<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">2020 Dec 11</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/25638515" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication.</a><span class="source">[J Vasc Surg. 2015]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Society for Vascular Surgery Lower Extremity Guidelines Writing Group, Conte MS, Pomposelli FB, Clair DG, Geraghty PJ, McKinsey JF, Mills JL, Moneta GL, Murad MH, Powell RJ, et al. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">J Vasc Surg. 2015 Mar; 61(3 Suppl):2S-41S. Epub 2015 Jan 28.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/27181397" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia.</a><span class="source">[Curr Treat Options Cardiovasc ...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Medical Therapy in Peripheral Artery Disease and Critical Limb Ischemia.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Foley TR, Waldo SW, Armstrong EJ. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Curr Treat Options Cardiovasc Med. 2016 Jul; 18(7):42. </em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=26065061" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=26065061" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c8d600a68b6b5afc40f962">Lower Limb Peripheral Arterial Disease</a><div class="ralinkpop offscreen_noflow">Lower Limb Peripheral Arterial Disease<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c8d5ffa68b6b5afc40f0ec">Antibiotics for Early-Onset Neonatal Infection</a><div class="ralinkpop offscreen_noflow">Antibiotics for Early-Onset Neonatal Infection<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c8d5fea68b6b5afc40ed9b">Headaches</a><div class="ralinkpop offscreen_noflow">Headaches<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c8d5fdf4a390645efdaa06">Psoriasis</a><div class="ralinkpop offscreen_noflow">Psoriasis<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c8d5fcab82281a80085744">Psychosis and Schizophrenia in Children and Young People</a><div class="ralinkpop offscreen_noflow">Psychosis and Schizophrenia in Children and Young People<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
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