The first session of this year’s CX International Symposium began with a variety of presentations highlighting both clinical and technological issues facing vascular and endovascular specialists.
Dr Lars Norgren, Orebro, Sweden, began the session, discussing the merits and implications of TASC II, an Inter-Society Consensus for the Management of peripheral arterial disease (PAD) (16 vascular societies with representatives from Europe, USA, Canada, Japan, Australia and South Africa).
According to Norgren, TASC II is an upgrade from the original TASC document, with the recommendations graded and not over loaded with technical or procedural information. TASC II is based on the criteria of at least one randomised controlled clinical trial as part of the body of literature of overall good quality and consistency, addressing the specific recommendation; on well-conducted clinical studies but no good quality randomised clinical trial on the topic of recommendation; and on evidence obtained from expert committee reports or opinions and/or clinical experiences of respected authorities (i.e. no applicable studies of good quality).
The epidemiology is the same as TASC and includes; management of risk factors; treatment of intermittent claudication; treatment of critical limb ischaemia; treatment of acute ischaemic; revascularisation; and imaging.
Norgren said that the implications of TASC II were: to increase awareness of PAD among referral sources; to highlight the close relation diabetes/PAD; to point out risk factors, smoking, lipids, hypertension; to achieve uniform management of PAD; to point at podiatric procedures post-revasculariation; and to point out the role of endovascular vs. open procedures, related to type and extension of lesion. Therefore, its recommendations highlights exercise; pharmocotherapy (cilostazol); rest pain; diabetes; referrals; multi-disease; and revascularisation.
In order to convey their message to vascular specialists, the authors of TASC II have stated that they need to increase cooperation with national societies, increase local meetings and well as educational material and improve access with and communication to the media.
It would seem that the majority of delgates welcomed the TASC II recommendations, with 66% agreeing that they were representative of current clinical practice (34%) voting against. Speaking to CX Daily News, Norgren commented, “With nearly 70% of the audience acknowledging the importance of TASC II, the next step is to educate the people in their primary care trusts.”
