THE SAGE GROUP Comments on National Peripheral Artery Disease (PAD) Awareness Month

“Twenty years ago we wrote that PAD was underestimated, underdiagnosed and undertreated,” stated Mary L. Yost, President. “Unfortunately, this is still true.”

Reflecting on the current state of PAD and the changes that have occurred Yost observed, “There have been many positive developments, especially technological innovations in treatment. However, PAD is still an ‘orphan disease’ in terms of knowledge, awareness and 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 and outpatient labs, resulting in significant reductions in amputations.”

“Progress in increasing disease awareness among the public and the gatekeeper physicians has been slow,” she cautioned. “The result is continued underdiagnosis and undertreatment, causing unnecessary morbidity and mortality, especially among Blacks, Hispanics, Native Americans and females. Furthermore, treatment is delayed until the most severe stages, which significantly drives up costs.”

“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. PAD mortality exceeds that of breast cancer and coronary artery disease. Yet cardiovascular 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, Yost observed, “Frequently, there is a significant disconnect between what is possible technologically, and the actual treatments offered to patients.”

“Major amputation is often the first, and the only treatment offered for CLI,” Ms. Yost continued. “In 60%-70% of patients who undergo major amputation there is no attempt at revascularization. Furthermore, although an angiogram is highly protective against major amputation, reducing the odds by 90%, over half 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 and intermittent claudication. The most recent research focuses on PAD in African Americans. Additional information: www.thesagegroup.us.