Updates to Medical Management of Patients with Arterial Claudication

Monday, March 25, 2024

5:05 PM – 5:10 PM MT

Abstract Presenter(s)

Alexander Andrew Argame, BSN, RN (he/him/his)

Medical Student
Kaiser Permanente Bernard J. Tyson School of Medicine

Financial relationships: Full list of relationships is listed on the CME information page.

Author/Co-author(s)

HM

Huma Manjra, BS

Medical Student
Kaiser Permanente School of Medicine

Disclosure information not submitted.
MA

Mohammed AlDajani, BS

Medical Student
Kaiser Permanente School of Medicine

Disclosure information not submitted.
AB

Alok Bhatt, MD

Assistant Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente physician

Financial relationships: Full list of relationships is listed on the CME information page.

Learning Objectives: This educational exhibit will discuss optimal outpatient medical management for patients with peripheral arterial disease experiencing arterial claudication, including AHA/ACC guideline-directed management and therapy (GDMT).7

Background: Appropriate medical management of patients with arterial claudication can improve functional status, quality of life, and leg symptoms,19 while potentially decreasing incidence of future major atherosclerotic cardiovascular disease or limb-related events.4 Cardiovascular risk reduction through pharmacotherapy, as well as leg symptoms improvement are paramount to medical management.

Clinical Findings/Procedure Details:
Cardiovascular risk reduction discussion will encompass pharmacotherapy, including:
• Cholesterol management through statin 1 use/considerations/goals and statin alternatives including Ezetimibe,12 PCSK9 Inhibitors,12 and Bempedoic Acid 14
• Glycemic control including GLP1 Receptor Agonists 11 and SGLT2 Inhibitors 10, 21, 22
• Hypertensive management including ACE Inhibitors and ARB’s 2
• Antiplatelet therapy comparing aspirin, P2Y12 ADP inhibitors, and dual-combination therapies 7
• Anticoagulant therapy exploring factor Xa inhibitors 3, 9
• Smoking cessation/counseling 7
• Influenza vaccination 7
Leg symptom improvement discussion will include:
• Role of statins 8
• Cilostazol 5 and contraindications
• Hydration and albumin complement protocol 18
• Structured Exercise Therapy comparing/contrasting supervised exercise program vs. structured community- or home-based exercise program,7 while considering alternative strategies including arm ergometry,20 leg cycling,20 resistance training,17 pain-free treadmill training,15 and various exercise intensity levels 6, 13, 16

Conclusion and/or Teaching Points:
In conclusion, this exhibit will highlight GDMT and updates for claudicants.