“Peripheral Artery Disease (PAD)...most commonly affects the arteries of the lower limbs, with blockages that restrict bloodflow to the legs and feet. The disease can cause troublesome symptoms that include claudication (pain brought on by walking) as well as both pain at rest and the formation of non-healing ulcers when the condition is severe. At best, the quality of life of patients with PAD can be significantly reduced; at worst, the condition can lead to amputation and premature death.” – Improving Patient Experience by Addressing Unmet Needs in Vascular Disease, Abbott, 2021
David G. Armstrong
Peripheral artery disease (PAD) is a chronic condition that impacts over 200 million people worldwide and requires ongoing care to ensure patients maintain optimal vascular health. Just like cancer, vascular disease is not cured, and interventional treatment only puts patients in remission. This is especially true in cases of restenosis with ischemia or re-ulceration with diabetic foot complications. Therefore, the interdisciplinary care team must prioritize the patient's needs from the very beginning of their treatment journey all the way to the end.
While the procedure to address an acute episode of vascular disease is only one moment in the on-going comprehensive care of patients, a focus on limb preservation and podiatric and vascular interdisciplinary intervention will ensure patients receive the best care possible. Another key element to the success of this interdisciplinary intervention is ensuring the patient is fully informed by their care team and that their voice is heard when making decisions for their care. This shared decision-making framework, as discussed in Abbott’s Beyond Intervention Year 3 paper, has been shown to increase patient compliance, treatment satisfaction, and decrease conflict.
Limb preservation is a critical aspect of vascular care that focuses on preventing amputations. In some cases, amputations may be necessary to save a patient's life. However, in most cases, they can be prevented by identifying and treating the underlying cause of the vascular disease. This is where podiatric/vascular intervention comes in. Podiatric intervention is a vital component of limb preservation as it focuses on the care of the foot and ankle. Vascular intervention, on the other hand, focuses on opening blocked arteries to improve blood flow. This kind of intervention is essential in treating the underlying vascular disease that may lead to foot and ankle complications.
Working together, podiatric, and vascular specialists can put the patient at the center of the care team to deliver optimal outcomes. This core, often called the “Toe and Flow” model, has been shown to have a dramatic effect on amputation reduction, especially when supported by the rest of the interdisciplinary team.
Patients with vascular disease require a comprehensive evaluation to determine the extent of their disease and the underlying causes. The evaluation may involve various diagnostic tests, including angiography, ultrasound, and other imaging modalities. Once the diagnosis is made, the podiatric/vascular care team develops a treatment plan tailored to the patient's needs. The plan may include lifestyle changes, medication, and various procedures such as angioplasty or bypass surgery. Afterward, the care team continues to work with the patient to ensure their fidelity to the plan and maintenance of their vascular health.
Together, we must collectively work to make sure that patients receive comprehensive care, from diagnosis, to intervention, and beyond.
Read more about the importance of shared decision-making and post-intervention care for vascular patients in Abbott’s latest research here.