Conservative (Non-surgical) Management

All patients with PVD should be managed with conservative management and BMT, including those who have also undergone an intervention (endovascular and/or surgery). As a guide, for those undergoing conservative management alone, about a third of patients will improve, a third will stay the same and about a third will suffer symptomatic deterioration over a 6-month period.

Revascularisation

This includes angiointervention or open surgery. The decision to proceed will depend on numerous factors:

• General health versus risks of procedure (30% mortality <5 years!).
  
• Vessel suitability (length and number of lesions).
  
• Is there a suitable access site (angiointervention)?
  
• Is there a suitable distal target vessel for anastomosis (surgery)?
  
• Is amputation a better option (poor health/non-reconstructable)?