Diabetes & Peripheral Arterial Disease:

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Are you at risk for Peripheral Arterial Disease (PAD)?DO YOU HAVE:Cardiovascular (heart) problems such ashigh blood pressure, heart attack, stroke?DiabetesA family history of diabetes or cardiovascular problems?(immediate family such as parent, sister, brother)Aching, cramping or pain in your legs when you walk orexercise, but then the pain goes away when you rest?Pain in your toes or feet at night?Any ulcers or sores on your feet or legs that are slow in healing?An inactive lifestyle?Do you smoke?Have you ever smoked?Yes NoYes NoYes NoYes NoYes NoYes NoYes NoYes NoYes No
Diagnostic Critical PathwayClinical Evaluation:History and PhysicalABI AvailableABI Not AvailablePADDiagnosisReferral to Vascular Lab• Assessment of location/severity is desired• ABI >1.3• Normal ABI but PADsuspicion is highVascular Lab Evaluation• Segmental pressures• Pulse volume recordings• TreadmillPADDiagnosisAdapted from American Diabetes Association. Diabetes Care. 2003;26:3333-3341.
Page 1 and 2: Diabetes &Peripheral Arterial Disea
Page 3: Atherosclerosis is aSystemic Diseas
Page 6 and 7: PAD : Survival Curve1.000.75NormalS
Page 8 and 9: Impact on Quality of Life↓ Walkin
Page 10 and 11: Common Risk Factors for PAD*◄Less
Page 12 and 13: Prevalence of PAD in DMPAD is 20x m
Page 14 and 15: Tragic “Rule of 15”15% DM15% fo
Page 16 and 17: Problem with PAD isUnderdiagnosed &
Page 18 and 19: Clinical Presentations of PADClassi
Page 20 and 21: Critical Limb Ischaemia (CLI)Chroni
Page 22 and 23: Relying on classic history ofclaudi
Page 24 and 25: • Colour• Deformities• Ulcer
Page 28 and 29: Ankle Brachial Index (ABI)ABI =Lowe
Page 30 and 31: Interpretation of the ABIInterpreta
Page 33 and 34: Who should be screened with ABI?1.
Page 35 and 36: MRA & CTAPlanning forrevascularizat
Page 37 and 38: PAD Treatment GoalsImproveFunctiona
Page 39 and 40: Conservative TreatmentA- anti-plate
Page 41 and 42: Cilostazol (Pletaal)Antiplateletact
Page 43 and 44: Prevention of Amputation in DMRegul
Page 45 and 46: 60M, smoker, DM, lipid, CAD, CVA,bi
Page 47 and 48: Surgical Morbidity & MortalityWound
Page 49 and 50: Advantages of EndovascularTreatment
Page 51 and 52: Limb Salvage for CLIAvoid / Limit a
Page 53 and 54: Changing pattern ofrevascularizatio
Page 55: 74M, DM, Smoker, 1mth infected foot
Page 61 and 62: Ray amputation same admissionMeticu
Page 63 and 64: NO!
Page 65 and 66: SFA Compressive Forces: StentFractu
Page 67: “Fracture Resistant” SE Stents1
Page 70 and 71: Which Patients to Refer?Difficult D
Page 72 and 73: Key RoleTake Home Massage:Role of G
Page 74: Save a Leg . . . Save a LifeThank Y

Diabetes & Peripheral Arterial Disease:

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