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12. Longitudinal Follow-Up of PAD
COR LOE
Recommendations
General Principles
1 C-EO
1. In patients with PAD, with or without revascularization,
longitudinal follow-up with routine clinical evaluation, including
assessment of limb symptoms and functional status, lower
extremity pulse and foot assessment, and progress of risk factor
management is recommended.
1 C-EO
2. In patients with PAD, coordination of care among clinicians to
improve the management of PAD and comorbid conditions and to
optimize patient outcomes is recommended.
Functional Status and QOL
1 B-NR
3. In patients with PAD, with or without revascularization, periodic
assessment of functional status as well as overall health-related
QOL as a component of longitudinal follow-up is recommended.
Medical erapy
1 A
4. In patients with PAD, long-term use of GDMT to prevent
MACE and MALE is recommended.
Postrevascularization Follow-Up
1 C-LD
5. In patients with PAD who have undergone lower extremity
revascularization (ie, surgical and/or endovascular), longitudinal
follow-up that includes periodic clinical evaluation of lower
extremity symptoms and pulse and foot assessment is recommended.
1 C-LD
6. In patients with PAD who have undergone lower extremity
revascularization (ie, surgical, endovascular, or both) with new
lower extremity signs or symptoms, ABI and arterial duplex
ultrasound is recommended.
2a B-R
7. In patients with PAD who have undergone infrainguinal,
autogenous vein bypass graft(s) without new lower extremity signs
or symptoms, it is reasonable to perform ABI and arterial duplex
ultrasound surveillance within the first 1 to 3 months postprocedure,
then repeat at 6 and 12 months, and then annually.
2a C-LD
8. In patients with PAD who have undergone endovascular
procedures without new lower extremity signs or symptoms,
it is reasonable to perform ABI and arterial duplex ultrasound
surveillance within the first 1 to 3 months postprocedure, then
repeat at 6 and 12 months, and then annually.
2b B-NR
9. In patients with PAD who have undergone infrainguinal,
prosthetic bypass graft(s) without new lower extremity signs
or symptoms, the effectiveness of ABI and arterial duplex
ultrasound surveillance is uncertain.
Telehealth
2a C-LD
10. For patients with PAD, telehealth can be an alternative mode for
vascular evaluation and management and longitudinal follow-up,
but the use of these visits should be consistent with the urgency
of presenting symptoms.