Table 2.

Summary of Gaps Related to PAD in Research, Clinical Practice, and Implementation

Research/clinical gaps

Contemporary data on the prevalence of PAD in the United States and globally

Larger studies with toe-brachial index (diagnostic accuracy and prognosis)

New and noninvasive techniques to visualize peripheral perfusion

Nonconventional risk factors and microvascular disease as potential preventive and therapeutic targets of PAD

Research to identify characteristics of effective home-based exercise interventions that are acceptable and accessible to patients with PAD

Behavioral methods to help patients with PAD adhere to home-based exercise long term

Community-based studies with severe leg outcomes

Randomized clinical trials comparing medical therapy, percutaneous revascularization, and surgical revascularization (with their latest evolutions) by indication and clinical staging

Medications or other oral therapies that significantly improve walking performance in PAD

Prediction models for developing critical limb ischemia and requiring lower extremity amputation

All PAD-related studies should include racially/ethnically diverse populations

Implementation gaps

Awareness of PAD among health care providers and patients

Screening of PAD with ankle-brachial index in high-risk populations

Broader use of toe-brachial index beyond ankle-brachial index>1.4, especially among patients with diabetes or chronic kidney disease

Adherence to evidence-based therapies in patients with PAD (medical therapies, supervised exercise therapy, and home-based exercise)

Avoiding unnecessary revascularization

All these implementation gaps should be filled across racially/ethnically diverse populations

PAD indicates peripheral artery disease.