Lesson 1Indications for revascularisation: endovascular vs open surgery, patient selection, peri-procedural planning, and outcomesOutlines when to opt for revascularisation in claudication or limb-threatening ischaemia. Compares endovascular and open surgical approaches, patient suitability, pre-procedure planning, and realistic outcomes for vessel patency and function.
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 basisCovers antiplatelet medicines, statins, blood pressure drugs, and diabetes control in PAD. Key points include treatment goals, major studies, choosing drugs with other conditions, and tips to boost adherence while cutting side 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)Step-by-step guide to ABI measurement, patient prep, and equipment. Covers reading thresholds, common issues like vessel calcification, and extra tests when ABI is misleading or unclear.
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 basics for PAD, scanning methods, and segment checks. Stresses waveform shapes, velocity ratios, and standards for spotting narrowing and key blockages.
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 artefactsDiscusses CTA and contrast MRA uses, risks, and best protocols. Reviews image capture, processing, and spotting artefacts that can hide or mimic arterial issues.
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 factorsExamines plaque buildup in leg arteries, progression, and blood flow effects. Highlights body-wide risks, their interplay, and links to limb lack of blood and heart problems.
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)Protocols for treadmill tests, toe-brachial index, and TcPO2. Covers standards, safety, reading levels, and role in diagnosis, outlook, and treatment choices for 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 metricsPlans follow-up schedules post-PAD diagnosis or procedure. Includes monitoring tests, wound checks, referral signs, and tracking prevention to avoid amputations and heart 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 programmes: prescription, expected benefits, and monitoringDetails supervised walks, home exercises, and prescriptions. Covers benefits, timelines, cautions, and ways to track compliance, symptoms, and improvements.
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 ischaemiaTypical signs of claudication and critical limb ischaemia. Distinguishes PAD from nerve, muscle, or vein leg pain causes for proper checks and referrals.
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 basicsQuick spotting of acute limb ischaemia, checks, and risk levels. Covers urgent blood thinners, scans, and vascular surgery links for clot busting or removal.
Clinical classification of acute limb ischemiaBedside vascular exam and Doppler useInitial anticoagulation and monitoringIndications for urgent vascular consultBasics of thrombolysis and embolectomy
