Why Screening for PAD matters
PAD or Peripheral Arterial Disease, is a highly prevalent disease, with morbidity and mortality similar to coronary artery disease, yet it has limited preventative screening.
PAD is a common circulatory problem in which narrowed arteries reduce the blood flow to the limbs. When PAD develops, the extremities, and in particular the legs, don’t receive enough blood flow to keep up with demand.
Over 70% of patients do not know that they have the disease because they do not feel or recognize the symptoms until severe complications occur.
The Ankle-Brachial Index screening is recommended for those in the PAD risk group for early detection of the disease. Who is in this risk group?
- Patients with clinical suspicion of PAD
- Patients with clinical conditions which may cause risk for PAD
- Asymptomatic individuals at risk for PAD
World-wide prevalence of PAD was estimated to be 237 million adults in 2015, up from 202 million in 2010, and is expected to continue to rise. 1,2
There are several established screening methods for PAD, ranging from a simple questionnaire to CT or MRI imaging. The most convenient, inexpensive and recommended method is an ABI (Ankle-Brachial Index) assessment, particularly if preformed with an automated diagnostic device. The ABI assessment is a non-invasive vascular screening test, calculated by dividing the highest systolic pressure in the ankle with the highest systolic pressure in the arm.
Despite the varying options for assessment and the many individuals involved in the high-risk groups, there is a gap in care of the ever-increasing PAD population. Cardiologists are not including peripheral vessel assessment in their regular cardiovascular check-ups. Many do not ask for vascular symptoms or conduct vascular screening tests. Yet PAD and other vascular disorders are the leading cause of cardiac diseases and stroke in patients.
Timely diagnosis and effective treatment of PAD and other vascular disorders can reduce the incidence of mortality in cardiac disorders. PAD screening should generally be done in adults over the age of 50 years old with cardiovascular risk factors and in all patients over 65.
The most prominent barriers to reliable and accurate screening and diagnosis of PAD are generally time limitation and lack of proper equipment, both maintainable using an ABI assessment performed by a diagnostic device.
Determining an ABI requires inexpensive equipment and can be performed by many different healthcare professionals. Until fairly recently, most ABI measurements were performed using a Doppler probe, and this method, while accurate and reliable, takes skill and can create errors if not performed correctly, not to mention the time involved – up to 30 minutes from start to finish.
That is why diagnostic devices, like the MESI ABPI, work so well because they are automatic (reducing user error) and the test can be performed in 1 minute, allowing health care professionals to screen a large number of patients in a day.
Reducing the time spent on diagnosis and treatments while providing the best level of care is becoming a significant benefit for all healthcare professionals and patients alike.
To learn more about diagnostic devices, like the MESI ABPI:
References:
[1] Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis > https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61249-0/fulltext
[2] Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis > www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30255-4/fulltext
