ATLANTA--()--According to THE SAGE GROUP LLC, peripheral artery disease (PAD) afflicts almost 18 million Americans costing the U.S. between $164 and $290 billion annually.
“The availability of new endovascular technologies and access techniques now enables skilled interventionalists to treat almost all patients and all lesions, whether located above or below the knee. In addition, multidisciplinary limb preservation programs have been established in many hospitals, resulting in a significant reduction in PAD-related amputations.”
“A decade ago we wrote that PAD was underestimated, underdiagnosed and undertreated,” stated Mary L. Yost, President of THE SAGE GROUP LLC. “Unfortunately, this statement is still true.”
Reflecting on the current state of PAD and the changes that occurred over the last 10 years Yost observed, “While there have been many positive developments, especially technological innovations in treatment, there are also many disappointments. PAD is still an orphan disease in terms of knowledge and awareness, and even in some aspects of treatment.”
According to Ms. Yost, “The availability of new endovascular technologies and access techniques now enables skilled interventionalists to treat almost all patients and all lesions, whether located above or below the knee. In addition, multidisciplinary limb preservation programs have been established in many hospitals, resulting in a significant reduction in PAD-related amputations.”
“However, progress in increasing disease awareness among the public and the gatekeeper physicians has been slower than we anticipated,” she cautioned. “The result is continued underdiagnosis and undertreatment causing unnecessary mortality and morbidity.”
“PAD is not just a leg problem. It is also a heart and a brain problem,” explained Yost. “Within 5 years, approximately 50% of PAD patients experience a heart attack or stroke, 30% of these are fatal. This mortality rate exceeds that of breast cancer or coronary artery disease.”
If diagnosed in the early stages, PAD patients can be treated with appropriate lifestyle modifications and drug therapies to reduce the risks of heart attack and stroke; exercise therapy to reduce the pain of claudication; or if blockages are more severe, with minimally invasive revascularization technologies. Compared with coronary disease patients, PAD patients continue to be inadequately treated for their risk factors.
Describing the current treatment of critical limb ischemia (CLI) Ms. Yost stated, “A paradox exists. Despite a decline in the number of major amputations, primary amputation is frequently the first, and the only treatment offered. Recent research has shown that 60%-70% of CLI patients who undergo major amputation have no attempt at revascularization prior to amputation. Amazingly, this situation has remained unchanged for over 30 years!”
“Although an angiogram has been shown to be highly protective against major amputation, reducing the odds by 90%, almost half of major amputations are performed without this basic diagnostic evaluation,” Yost added.
Summarizing the current therapeutic situation for the most severe stage of the disease Ms. Yost concluded, “There seems to be a significant disconnect between what is possible technologically and the actual treatments offered to CLI patients. Major geographic variations in the types and the amount of vascular care provided to CLI patients exist in this country. In 2012 we find this a sad state of affairs.”
For Patients and Those Interested in Amputation Prevention
Additional information about PAD and amputation prevention can be found at two nonprofit sites: the Save A Leg Save A Life Foundation at www.savealegsavealife.org and the Vascular Disease Foundation www.vdf.org.
THE SAGE GROUP, a research and consulting company, specializes in atherosclerotic disease in the lower limbs, specifically PAD (Peripheral Artery Disease), CLI (Critical Limb Ischemia), ALI (Acute Limb Ischemia) and ischemic diabetic foot ulcers (DFU). The most recent research focuses on quantifying the economic and social costs of PAD.
For additional information visit: www.thesagegroup.us.