Chinese expert consensus on management of peripheral arterial disease in the elderly

Abstract:

Lower extremity arteriosclerosis obliterans, also known as peripheral artery disease (PAD), is a chronic arterial occlusive disease characterized by atherosclerosis affecting the arteries of the lower extremities, leading to luminal stenosis or occlusion, and consequently resulting in ischemia and necrosis of the lower limbs. PAD not only significantly reduces patients' quality of life but also carries a non-negligible risk of amputation and mortality, imposing a heavy economic and health burden on both patients and society, especially among the elderly. Advanced age has been identified in multiple studies as a key risk factor for amputation and death in PAD patients. The prevalence of PAD in the elderly increases significantly with age, as they often have multiple coexisting conditions such as coronary artery disease, renal insufficiency, and tumors. Consequently, the pathophysiological characteristics, treatment options, and prognostic assessments are more complex compared to those of younger patients. Diagnostically, because comorbidities can often mask the symptoms of PAD in elderly patients, a comprehensive approach involving detailed medical history, physical examination, and auxiliary tests is required. In terms of treatment, the management of elderly patients with PAD is further complicated by issues such as poor adherence to therapy and difficulties in follow-up, which increase the challenges in clinical management. Currently, there is a lack of specific national or international guidelines or consensuses focused on the diagnosis and treatment of PAD in the elderly. To address this gap, the "Chinese expert consensus on the management of lower extremity atherosclerotic disease in the elderly" has been developed. This consensus integrates the latest evidence-based medical data and clinical experience, with a focus on key issues in elderly PAD patients, such as disease characteristics, comorbidity management, personalized treatment, and long-term follow-up. It aims to establish scientific and practical diagnostic and therapeutic standards to provide guidance for clinicians.