Quality of life: an often neglected evaluation in patients with peripheral arterial disease

Peripheral arterial disease is a common clinical condition and represents a manifestation of systemic atherosclerosis. It has been demonstrated that peripheral arterial disease impairs significantly quality of life, and thus its improvement has become an important goal of therapy, particularly in symptomatic patients. In addition, the impact of this disease on quality of life is not adequately described by physical examination findings and common clinical data, such as the ankle-brachial index. Thus, to properly understand the clinical evolution of peripheral arterial disease and its treatment, it is useful to integrate clinical outcome measures with data derived from the patient's point of view in order to avoid that procedural success is evaluated only in terms of appropriate use of the available technical tools and of a good angiographic result without taking into account its consequences on daily future life of patients. It would therefore be necessary that the caregivers involved in the evaluation and treatment of patients with peripheral arterial disease are able to use and interpret the validated instruments for quality of life assessment. Among therapeutic strategies, percutaneous transluminal angioplasty is emerging as a suitable option to improve both clinical outcome and quality of life, even though it cannot contrast the progression of atherosclerotic disease. In this article we review major generic and specific instruments to assess patient-reported quality of life. Moreover, we describe the impact of peripheral arterial disease and its endovascular treatment on quality of life.