{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:21:06Z","timestamp":1791984066972,"version":"4.4.0"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Peripheral artery disease (PAD) is the lower limb manifestation of systemic atherosclerotic disease. PAD may initially present with symptoms of intermittent claudication, whilst chronic limb-threatening ischaemia (CLTI), the end stage of PAD, presents with rest pain and\/or tissue loss. PAD is an age-related condition present in over 10% of those aged \u226565 in high-income countries. Guidelines regarding definition, diagnosis and staging of PAD and CLTI have been updated to reflect the changing patterns and presentations of disease given the increasing prevalence of diabetes. Recent research has changed guidelines on optimal medical therapy, with low-dose anticoagulant plus aspirin recommended in some patients. Recently published randomised trials highlight where bypass-first or endovascular-first approaches may be optimal in infra-inguinal disease. New techniques in endovascular surgery have increased minimally invasive options for ever more complex disease. Increasing recognition has been given to the complexity of patients with CLTI where a high prevalence of both frailty and cognitive impairment are present and a significant burden of multi-morbidity and polypharmacy. Despite advances in minimally invasive revascularisation techniques and reduction in amputation incidence, survival remains poor for many with CLTI. Shared decision-making is essential, and conservative management is often appropriate for older patients. There is emerging evidence of the benefit of specialist geriatric team input in the perioperative management of older patients undergoing surgery for CLTI. Recent UK guidelines now recommend screening for frailty, cognitive impairment and delirium in older vascular surgery patients as well as recommending all vascular surgery services have support and input from specialist geriatrics teams.<\/jats:p>","DOI":"10.1093\/ageing\/afae114","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T18:05:09Z","timestamp":1717005909000},"source":"Crossref","is-referenced-by-count":44,"title":["New Horizons in Peripheral Artery Disease"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9159-5307","authenticated-orcid":false,"given":"John S M","family":"Houghton","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester , Leicester , UK"},{"name":"Leicester Vascular Institute , University Hospitals of Leicester NHS Trust, Leicester , UK"},{"name":"National Institute for Health Research Leicester Biomedical Research Centre\u2014The Glenfield Hospital , Leicester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios N","family":"Saratzis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester , Leicester , UK"},{"name":"Leicester Vascular Institute , University Hospitals of Leicester NHS Trust, Leicester , UK"},{"name":"National Institute for Health Research Leicester Biomedical Research Centre\u2014The Glenfield Hospital , Leicester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob D","family":"Sayers","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester , Leicester , UK"},{"name":"Leicester Vascular Institute , University Hospitals of Leicester NHS Trust, Leicester , UK"},{"name":"National Institute for Health Research Leicester Biomedical Research Centre\u2014The Glenfield Hospital , Leicester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria J","family":"Haunton","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Plymouth , Plymouth , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"2024061504483634500_ref1","article-title":"European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication","volume":"67","author":"Nordanstig","year":"2023","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024061504483634500_ref2","doi-asserted-by":"crossref","first-page":"e1020","DOI":"10.1016\/S2214-109X(19)30255-4","article-title":"Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and 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