Peripheral arterial disease

• Aspirin, Clopidogrel (alternative), Atorvastatin, Cilostazol (walking pain; not in heart failure)

• Exercise and smoking: Supervised walking 30–45 min, 3 times a week; stop all tobacco; check ABI and sugar (ESC 2024; ACC/AHA 2024)

First visit

• Ankle–brachial index (ABI) — Under 0.9 confirms PAD; over 1.4 means stiff arteries (use toe pressure).
• Blood glucose / HbA1c, lipid profile, creatinine — Risk factors.
• ECG — Coronary disease is common.

Only if indicated

• Arterial Doppler of the legs — Before any intervention, or rest pain or ulcer.
• CT angiography — Planning revascularisation.