The practice guideline 'Peripheral vascular disease' (first revision) from the Dutch College of General Practitioners: a response from the perspective of surgery
Legemate, D.A.
Nederlands Tijdschrift Voor Geneeskunde 148(30): 1480-1481
2004
ISSN/ISBN: 0028-2162 PMID: 15481569 Document Number: 569205
The practice guideline 'Peripheral vascular disease' is well written and based on evidence-based principles. In comparison with the previous guideline considerable attention is given to secondary prevention. In this guideline general practitioners are more diffident about prescribing statins than vascular specialists. This is probably related to the fact that this guideline refers to another guideline of the College concerning the treatment of patients with high-cholesterol concentrations and not to recently-published large studies. The guideline advises making a distinction between intermittent claudication stage 2a and 2b. This is impractical as the choice of therapy depends on the subjective feelings of disability. Some controversy remains with respect to the detection of asymptomatic abdominal aneurysms: should there routinely be only physical examination or ultrasonographic screening as well? The guideline advises against routine ultrasonic screening, which is in line with the view held by the author of this commentary.