The screening process for PAD is simple and consists of checking for the two pulses in each foot once a year. If either of these pulses are present during the screening process then the circulation to the foot is perceived to be adequate. These pulses are the Dorsalis Pedis (DP) and the Posterior Tibial (PT). The patient should be asked if they have any signs of intermittent claudication (cramping in the calf muscle after walking a certain distance) and also be given advice regarding lifestyle changes, most importantly stopping smoking.
If during the screening process the pulses cannot be palpated or the patient presents with any of the aforementioned problems they will need to be referred for a more in depth assessment of their PAD, leading to the implementation of a management plan including a supervised exercise programme to try and improve the situation. There is good evidence to suggest that early identification of both asymptomatic and symptomatic PAD means that treatment can begin earlier, potentially slowing disease progression and improving quality of life through better mobility and reduced pain. Early identification and treatment of PAD and its risk factors may also reduce the risk of cardiovascular morbidity and mortality, and the need for lower limb amputation.
- NICE: Peripheral arterial disease: Quality standard [QS52]
- NICE: Peripheral arterial disease: diagnosis and management: Clinical guideline [CG147]