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<p>Peripheral arterial occlusive disease (PAOD) is a&#xa0;frequent manifestation of atherosclerosis associated with high morbidity and mortality. This article summarizes the current recommendations of the German S3 guidelines “Diagnostics, treatment and follow-up of PAOD” (Association of the Scientific Medical Societies in Germany, AWMF 2024) and discusses the implications of the ongoing hospital reform. Key diagnostic modalities include patient history taking, clinical examination, ankle-brachial index measurement and duplex ultrasonography. In cases of suspected chronic limb-threatening ischemia (CLTI), the WIfI score enables a&#xa0;structured risk assessment for amputation. Treatment management emphasizes strict secondary prevention (low-density lipoprotein, LDL &lt; 3,1 mmol/l, smoking cessation), supervised exercise training and optimized antithrombotic therapy (clopidogrel is preferred; dual pathway inhibition for high-risk patients or after revascularization). Revascularization can be performed endovascularly or surgically and increasingly in specialized centers. The German Hospital Reform supports the centralization of complex procedures and the expansion of outpatient care, thereby underscoring the pivotal role of nonvascular surgical departments in early detection and coordinated referral.</p>

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Leitlinienbasierte Diagnostik und Therapie der peripheren arteriellen Verschlusskrankheit

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Roland Mojica Crespo,
  • Ulrich Rother,
  • Markus Steinbauer

摘要

Peripheral arterial occlusive disease (PAOD) is a frequent manifestation of atherosclerosis associated with high morbidity and mortality. This article summarizes the current recommendations of the German S3 guidelines “Diagnostics, treatment and follow-up of PAOD” (Association of the Scientific Medical Societies in Germany, AWMF 2024) and discusses the implications of the ongoing hospital reform. Key diagnostic modalities include patient history taking, clinical examination, ankle-brachial index measurement and duplex ultrasonography. In cases of suspected chronic limb-threatening ischemia (CLTI), the WIfI score enables a structured risk assessment for amputation. Treatment management emphasizes strict secondary prevention (low-density lipoprotein, LDL < 3,1 mmol/l, smoking cessation), supervised exercise training and optimized antithrombotic therapy (clopidogrel is preferred; dual pathway inhibition for high-risk patients or after revascularization). Revascularization can be performed endovascularly or surgically and increasingly in specialized centers. The German Hospital Reform supports the centralization of complex procedures and the expansion of outpatient care, thereby underscoring the pivotal role of nonvascular surgical departments in early detection and coordinated referral.