Professional Practice Guide -FCSV-EN

29 for the Management of Peripheral Artery Disease 6.2 INDICATIONS FOR THE INVASIVE TREATMENT OF PAD Intermittent claudication  The natural course of IC is generally stable, with an annual risk of progression to critical ischemia of 2–3% and an annual risk of amputation of approximately 1%.²–³ For this reason, first-line treatment is conservative, consisting of medical management and a structured walking program. However, in patients who continue to experience significant limitations in mobility and quality of life despite conservative treatment, invasive treatment may be indicated as a second-line option, provided the revascularization procedure represents a reasonable risk for the patient.¹ Critical ischemia  As the most severe clinical presentation of PAD, critical ischemia is associated with a high annual risk of mortality (22%) and amputation (22%), even with adequate conservative treatment.⁴ In this context, semi-urgent invasive revascularization (within less than two weeks) is indicated. In addition to revascularization, these patients often require advanced wound care. In very advanced cases, primary amputation may be considered.¹ Acute ischemia  Unlike critical ischemia, acute ischemia is characterized by the rapid onset of symptoms due to a sudden reduction in blood supply to the leg. This condition limb viability and is associated with high mortality. Urgent revascularization is required.¹–⁵ Ӌ Dry gangrene of the toes of the right foot The natural course of intermittent claudication is generally relatively stable, with an annual risk of progression to critical ischemia of 2–3% and an annual risk of amputation of 1%.²–³