Recent guidelines strongly suggest exercise therapy prior to consideration for revascularization. In those patients with lifestyle-limiting claudication despite at least 3 months of exercise (ideally supervised), revascularization should be considered. While most patients are willing to participate in some form of exercise therapy, it is worth noting that a select group of patients experiencing claudication find SET excessively difficult. Such patients may insist on early revascularization due to symptom severity or their dependence on their ambulatory capacity for their vocation (e.g. a mailman or delivery person). As intervention in such settings is not supported explicitly in recent guidelines, consideration for early revascularization in such cases is made only after considerable patient-provider discussion. Once the patient’s symptoms demand therapy beyond exercise, the decision to revascularize and the method of revascularization depend on the patient’s clinical status and preferences and anatomic features.
Promoting an increased awareness and standardized approaches in diagnosing and treating peripheral artery disease