De standaard 'Perifeer arterieel vaatlijden' (eerste herziening) van het Nederlands Huisartsen Genootschap; reactie vanuit de chirurgie

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