New treatment guidelines against smoking peas (PAVK)

DGK presents new treatment guidelines for PAD

Peripheral arterial disease (PAD), better known as the "smoker's leg" or "intermittent claudication", affects around 4.5 million people in Germany. At the DGK Heart Days, which take place in Berlin from October 12 to 14, 2017, experts led by Prof. Dr. med. Christiane Tiefenbacher new treatment guidelines for PAD.

In a press release of the German Society of Cardiology (DGK), Prof. Tiefenbacher: "Insurance data from Germany show 500 to 600 new cases per 100,000 inhabitants each year. It is estimated that the number of over-40s suffering from PAD is now between five and ten percent. "PAVK is not only widespread, but many people also die of it. Because in PAD, there is also a high risk of cardiovascular disease. One third of all PAD patients have changes to the carotid artery and are therefore at an increased risk of suffering a stroke. Therefore secondary prophylaxis gains priority.

In the team to victory

Already in September 2017, the European Society of Cardiology (ESC) presented new treatment guidelines. The use of "vascular teams" consisting of cardiologists, angiologists and vascular surgeons should enable multidisciplinary treatment and thus increase the chances of success in combating PAD and its sequelae. Among other things, these guidelines recommend a lipid-lowering therapy with statin-type cholesterol-lowering drugs. According to the study data, the walking distance, which allowed patients to travel without pain, could be significantly improved.

New guidelines for the inhibition of blood clotting

Furthermore, the guidelines also address suitable drugs for inhibiting platelet clumping. "New to the European guidelines is that clopidogrel is considered to be more effective than aspirin in this respect, as the CAPRIE study shows," said Prof. Tiefenbacher. It is also recommended that PAOD patients receiving Marcumar or other anti-coagulant medicines should not take platelet aggregation inhibitors because of the increased risk of bleeding.

Gentle methods for PAVK treatment

For the treatment of the carotid artery, the guidelines favor stent implantation over surgical procedures. According to long-term studies, similar results could be achieved in both methods, but the stent implantation was far gentler for the patient.

Treatment of the legs

For the treatment of the legs, Prof. Tiefenbacher recommends: "Many constrictions can be gently treated by modern catheter technology for the patient." In complex situations, such as severe calcification, but according to the expert, and surgical procedures should come into play. With catheter Prof Tiefenbacher should be treated only in centers that have very experienced professionals. "If the condition of the veins in the lower leg is good, a bypass operation in which veins serve as a bridging of the closed arteries can also be carried out," the doctor continues. The results have improved here. (Fp)