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PAD screening: why? whom? when? how? - a systematic review

机译：垫筛查:为什么?系统综述

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An estimated 237 million people suffer from peripheral arterial disease (PAD), which is associated with high morbidity and mortality, and prevalence is still increasing. Currently, we do not have any randomized trials that compare screening to no screening specifically for PAD in the general population. Presently, PAD screening is not generally established. This systematic review gives an overview of relevant literature and guidelines. Screening usually focuses on ankle-brachial index (ABI)-measurement, which enables detection of asymptomatic and symptomatic PAD, but has limitations in diabetics. There are no sufficient data on PAD screening. Guideline recommendations are heterogeneous. While some advocate no screening until better data are available, most recommend selective screening despite insufficient data on morbidity and mortality reduction in consequence of screening. We support the only evidence-based screening strategy for PAD: combined screening for abdominal aortic aneurysm (AAA), PAD and arterial hypertension in men aged 65-74 according to the VIVA study. We additionally suggest a new simple three-step screening strategy for symptomatic PAD in all individuals aged 40 and older, who see a general practitioner: Asking one question ("Do you have pain or cramps in the legs during normal walking?") followed by physical examination (normal lower extremity pulse status?) in those, whose answer is "yes", and ABI measurement unless all pulses are normal.
机译：估计有2.37亿人罹患外周动脉疾病(PAD)与高发病率和死亡率有关,患病率仍在增加。没有任何比较的随机试验筛查没有专门为垫一般人群。通常没有建立。复习相关文献的概述和指导方针。踝肱指数(ABI)测量使检测无症状和症状垫,但在糖尿病患者有一定的局限性。没有足够的垫筛选数据。建议是异构的。提倡没有筛选,直到更好的数据可用,大多数建议选择性筛选尽管发病率和数据不足死亡率减少筛选的结果。我们支持唯一的以证据为基础的筛选垫的策略:结合筛查腹主动脉瘤(AAA),垫和动脉高血压在65 - 74岁的男性万岁。症状垫三步筛选策略在所有年龄在40岁以上,看到一个人(“全科医生:问一个问题你有疼痛或抽筋的腿在正常行走吗?”)体检紧随其后(正常下肢脉冲状态?),他的回答是“是的”,ABI测量除非吗所有脉冲是正常的。

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