4. Conclusion

In summary, the 2022 CCS guidelines for PAD should provide clinicians with guidance in the following areas: (1) diagnosis and screening of PAD; (2) optimal medical management for patients with PAD; (3) strategies to decrease risk and improve symptoms with smoking cessation therapies, medical therapies, and exercise programs; and (4) decisions regarding indications for interventions, assessing perioperative risk, and choosing between endovascular vs surgical approaches to revascularization. Approximately one-quarter (15/56) of the research questions received a strong recommendation with high-quality evidence, whereas 29% (16/56) were classified as weak recommendation with very low- or low-quality evidence, which illustrates the need for more evidence generation, particularly in preoperative risk assessment and interventional management of PAD patients. A gap in the medical management of patients with PAD has been reported by American and Canadian physicians for 20 years, and we hope that these guidelines will provide primary care, medical specialists, and vascular surgeons with the tools required to help close the treatment gap, and to improve the prognosis of patients with PAD.