Lesson 1Indications for revascularisation: endovascular vs open surgery, patient selection, peri-procedural planning, and outcomesDefines when to consider revascularisation for claudication and limb-threatening ischaemia. Compares endovascular and open options, patient selection, peri-procedural planning, and realistic expectations for patency and functional outcomes.
Indications in claudication versus CLIEndovascular techniques and devicesOpen surgical bypass principlesAnatomic and clinical selection factorsOutcome expectations and complication risksLesson 2Medical management: antiplatelet therapy, statins, antihypertensives, glycaemic control — drug classes, example agents, targets, and evidence basisReviews antiplatelet agents, statins, antihypertensives, and glucose-lowering drugs in PAD. Highlights treatment targets, key trials, drug selection in comorbidities, and strategies to improve adherence and minimise adverse effects.
Antiplatelet options and dosing in PADLipid lowering intensity and statin choiceBlood pressure targets and drug classesGlycemic control strategies in PADPolypharmacy, adherence, and monitoringLesson 3Ankle-brachial index (ABI): technique, interpretation, and limitations (including falsely elevated ABI)Provides stepwise ABI measurement technique, patient preparation, and equipment setup. Explains interpretation thresholds, pitfalls such as medial calcification, and complementary tests when ABI is falsely elevated or non-diagnostic.
Patient positioning and cuff selectionDoppler probe placement and readingsABI calculation and cutoff valuesRecognizing falsely elevated ABIWhen to use TBI or other adjunct testsLesson 4Duplex ultrasonography for PAD: waveform analysis, peak systolic velocity ratios, and segmental localisationExplains duplex ultrasound physics relevant to PAD, scanning technique, and segmental evaluation. Emphasises waveform morphology, peak systolic velocity ratios, and criteria for grading stenosis and localising haemodynamically significant lesions.
Probe selection and patient positioningArterial mapping and segmental approachWaveform patterns in health and diseasePeak systolic velocity ratio criteriaReporting and documentation standardsLesson 5Advanced vascular imaging: CTA and contrast-enhanced MRA indications, protocols, and common artefactsCovers CTA and contrast-enhanced MRA indications, contraindications, and protocol optimisation. Reviews image acquisition, reconstruction, and recognition of common artefacts that may mimic or obscure peripheral arterial disease.
Patient selection for CTA versus MRAContrast use, dosing, and safety issuesAcquisition parameters and reconstructionRecognition of motion and metal artifactsStrategies to reduce artifacts and misreadsLesson 6Pathophysiology of atherosclerotic peripheral artery disease (PAD) and risk factorsExplores atherosclerotic mechanisms in peripheral arteries, plaque evolution, and haemodynamic consequences. Emphasises systemic risk factors, their interactions, and how they translate into limb ischaemia and adverse cardiovascular outcomes.
Atherogenesis in peripheral arterial bedsEndothelial dysfunction and inflammationHemodynamic impact of stenosis and occlusionTraditional and emerging PAD risk factorsRisk factor clustering and global CV riskLesson 7Noninvasive functional tests: treadmill testing, toe-brachial index, and transcutaneous oxygen pressure (TcPO2)Details protocols for treadmill testing, toe-brachial index, and TcPO2. Focuses on standardisation, safety, interpretation thresholds, and how these functional tests guide diagnosis, prognosis, and treatment selection in PAD.
Treadmill protocols and safety measuresTreadmill test interpretation in PADToe-brachial index technique and cutoffsTcPO2 measurement setup and calibrationFunctional tests in treatment decision-makingLesson 8Follow-up strategies for PAD patients: frequency, surveillance tests, wound care referral triggers, and secondary prevention metricsOutlines structured follow-up intervals after PAD diagnosis or intervention. Reviews surveillance testing, wound assessment, referral triggers, and tracking of secondary prevention metrics to reduce limb loss and cardiovascular events.
Post-intervention surveillance schedulesUse of ABI and duplex in follow-upFoot exams and wound referral criteriaMonitoring risk factor control metricsPatient education and self-care plansLesson 9Exercise therapy and supervised walking programs: prescription, expected benefits, and monitoringDescribes supervised walking programs, home-based regimens, and structured exercise prescriptions. Discusses mechanisms of benefit, expected timelines, contraindications, and tools for monitoring adherence, symptoms, and functional gains.
Exercise prescription components in PADSupervised versus home-based programsMechanisms of improved walking distanceMonitoring symptoms and functional gainsContraindications and safety precautionsLesson 10Clinical presentation and differential diagnoses of intermittent claudication and critical limb ischaemiaClarifies typical features of intermittent claudication and critical limb ischaemia. Differentiates PAD from neurogenic, musculoskeletal, and venous causes of leg pain, guiding targeted evaluation and timely referral for advanced care.
Typical intermittent claudication featuresSigns of critical limb ischemiaNeurogenic versus vascular claudicationMusculoskeletal and venous mimickersKey history and exam for differentiationLesson 11Acute limb ischaemia recognition and first 24–48 hour management: anticoagulation, vascular surgery consult, thrombolysis and embolectomy basicsAddresses rapid recognition of acute limb ischaemia, bedside assessment, and risk stratification. Outlines immediate anticoagulation, imaging choices, and coordination with vascular surgery for thrombolysis, embolectomy, or urgent revascularisation.
Clinical classification of acute limb ischemiaBedside vascular exam and Doppler useInitial anticoagulation and monitoringIndications for urgent vascular consultBasics of thrombolysis and embolectomy
