DGK presents new treatment guidelines for PAVK
Around 4.5 million people in Germany suffer from peripheral arterial occlusive disease (PAD), better known as "smoker's leg" or "shop window disease". At the DGK Heart Days, which will take place in Berlin from October 12 to 14, 2017, experts led by Prof. Dr. Christiane Tiefenbacher presents new treatment guidelines for PAD.
In a press release from the German Society for Cardiology (DGK), Prof. Tiefenbacher warns: “Insurance data from Germany show 500 to 600 new cases per 100,000 inhabitants annually. According to estimates, the number of people over the age of 40 who suffer from PAD is now between five and ten percent. ”PAVK is not only widespread, the disease is also fatal in many patients. Because with PAD there is also a high risk of cardiovascular disease. A third of all PAD patients have changes in the carotid artery and are therefore at an increased risk of suffering a stroke. Therefore, secondary prophylaxis is becoming a priority.
The European Society of Cardiology (ESC) presented new treatment guidelines in September 2017. The use of "vascular teams", consisting of cardiologists, angiologists and vascular surgeons, is intended to enable multidisciplinary treatment and thus increase the chances of success in combating PAD and its secondary diseases. These guidelines recommend, among other things, lipid-lowering therapy with cholesterol-lowering drugs of the statin type. According to study data, the walking distance that patients could walk without pain could be significantly improved.
New guidelines for inhibiting blood clotting
Furthermore, the guidelines also deal with suitable medications for the inhibition of platelet clumping. "What is new in the European guidelines is that clopidogrel is considered to be more effective than aspirin in this regard, as the CAPRIE study shows," said Prof. Tiefenbacher. It is also recommended that PAVK patients who receive Marcumar or other medications to inhibit blood clotting should not take platelet aggregation inhibitors because of the increased risk of bleeding.
Gentle methods for PAD treatment
For the treatment of the carotid artery, stent implantations are preferred to surgical interventions in the guidelines. According to long-term studies, similar results could be achieved with both methods, but the stent implantation was much gentler on the patient.
Treatment of the legs
For the treatment of the legs, Prof. Tiefenbacher recommends: "Many constrictions can be treated gently for the patient using modern catheter technology." However, according to the expert, surgical procedures should also be used in complex situations, such as with a high degree of calcification. According to Prof Tiefenbacher, treatment with catheters should only be carried out in centers that have very experienced specialists. "If the veins in the lower leg are in good condition, a bypass operation can also be carried out, in which veins are used to bridge the closed arteries," continued the doctor. The results have improved here. (fp)