As a cardiovascular surgeon, I am in constant contact with patients suffering from peripheral arterial disease. Usually, they present with pain at rest or with gangrene. Lack of preventive measures by general practitioners allows PAD to develop asymptomatically. Therefore, more ABI measurements should be performed at the primary level. But, in reality, they are not.
The peripheral arterial disease affects individual´s life style with clutching pain in the lower extremities at exercise. Claudication arises during the activity such as walking and ends shortly after patient´s rest. When I hear that the individual is not able to walk more than 300 meters without rest, I wish that their PAD had been diagnosed much earlier or that I could offer them a less invasive surgical procedure and improve their quality of life. But I know that their PAD has already progressed to the very late stage. Consequently, aspirin and statins are not enough – the patient needs angioplasty or bypass surgery.
The TASC II guidelines are stating the importance of measuring ABI on a primary level and from my experience, I can tell that preventive measures are improving in the public health arena. Awareness of PAD is growing, but the percentage of asymptomatic patients diagnosed at the early stage of the disease is still low. The lack of preventive measures is clearly shown with 75% of patients being under treated. ABPI MD offers a straight forward, simple, objective and accurate method of ABI measurement. Consequently, the use of the Automated ankle-brachial index measuring device in recommended in every general practitioner´s office.
UNIVERSITY MEDICAL CENTRE LJUBLJANA