According to research conducted by THE SAGE GROUP, in 2015 almost 20 million Americans suffered from PAD representing an economic burden of $212-$389 billion.
“Almost 15 years ago we wrote that PAD was underestimated, underdiagnosed and undertreated,” stated Mary L. Yost, President of THE SAGE GROUP LLC. “Unfortunately, this is still true.”
Reflecting on the current state of PAD and the changes that have occurred Yost observed, “While there have been many positive developments, especially technological innovations in treatment, we have seen many disappointments. PAD is still an ‘orphan disease’ in terms of knowledge and awareness, as well as in 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 and 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. However, compared with coronary disease patients, risk factor treatments are underutilized in PAD patients.
Describing the current therapeutic situation for critical limb ischemia (CLI), the most severe stage of the disease, Ms. Yost observed, “Frequently, there is a significant disconnect between what is possible technologically, and the actual treatments offered to CLI patients.”
“Even though amputations have declined, primary amputation is often the first, and the only treatment offered for CLI,” Ms. Yost continued. “Sixty to 70% of CLI patients who undergo major amputation have no attempt at revascularization prior to the amputation. Furthermore, 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.”
THE SAGE GROUP, a research and consulting company, specializes in atherosclerotic and venous disease in the lower limbs, specifically PAD, CLI, intermittent claudication (IC) and ischemic diabetic foot ulcers (DFU). The most recent research focuses on the costs and consequences of amputation and the epidemiology and costs chronic venous disease. Additional information: www.thesagegroup.us.
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Last updated on: 14/09/2016
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