(1) In healthcare centres, it is recommended to set up a multidisciplinary Vascular Team to take decisions for the management of patients with peripheral arterial diseases (PADs). (2) All patients with any presentation of PADs are at high risk for cardiovascular events and mortality. Best medical therapy with control of risk factors including statins to reach secondary prevention targets are mandatory. (3) Antiplatelet therapy is indicated in all patients with carotid artery stenosis irrespective of clinical symptoms and revascularization. Dual antiplatelet therapy should be given for at least 1 month after carotid artery stenting. (4) The majority of recently symptomatic patients with carotid stenosis will gain maximum benefit when carotid interventions are performed within 14 days of symptom onset. (5) In patients with an asymptomatic 60–99% carotid stenosis, carotid surgery should be considered in the presence of clinical and/or more imaging characteristics (contralateral TIA/stroke, ipsilateral silent infarction, spontaneous embolization on transcranial Doppler, echolucent plaques, intraplaque haemorrhage) that may be associated with an increased risk of late ipsilateral stroke, provided documented perioperative stroke/death rates are<3% and the patient’s life expectancy exceeds 5 years. Carotid stenting is an alternative to surgery. (6) In patients with renal artery atherosclerotic disease, renal revascularization is not indicated as it does not improve blood pressure, renal, or cardiovascular outcomes. With few exceptions, medical therapy with antihypertensive agents, antiplatelet drugs, and statins remain the cornerstone for management of patients with renal artery disease. (7) Chronic limb-threatening ischaemia specifies clinical patterns with a vulnerable limb viability related to several factors. The risk is stratified according to the severity of ischaemia, wounds, and infection. Early recognition of tissue loss and/or infection and referral to the vascular specialist is mandatory for limb salvage. (8) In patients with lower-extremity arterial disease (LEAD), the data from an anatomical imaging test should always be analysed in conjunction with symptoms and haemodynamic tests prior to treatment decision. (9) Multisite arterial disease is common in patients with atherosclerotic involvement in one vascular bed, ranging from 10–15% in patients with CAD to 60–70% in patients with severe carotid stenosis or LEAD. Multisite arterial disease is invariably associated with worse clinical outcomes; however, screening for asymptomatic disease in additional vascular sites has not been proven to improve prognosis. (10) Besides coronary artery disease, other cardiac conditions such as heart failure and atrial fibrillation are frequent and prognostic. In stable patients with PADs who also have AF, anticoagulation is the priority and suffices in most cases. In case of recent endovascular revascularization, a period of combination therapy (anticoagulantþ antiplatelet therapies) should be considered according to the bleeding and thrombotic risks. The period of combination therapy should be as brief as possible.

中文翻译：

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2017年ESC外周动脉疾病诊治指南“十诫”

(1) 在医疗保健中心，建议成立一个多学科的血管团队来决定外周动脉疾病（PADs）患者的管理。(2) 所有有任何 PAD 表现的患者都有发生心血管事件和死亡的高风险。控制危险因素（包括他汀类药物）以达到二级预防目标的最佳药物治疗是强制性的。(3) 无论临床症状和血运重建情况如何，所有颈动脉狭窄患者均适用抗血小板治疗。颈动脉支架置入术后应给予双联抗血小板治疗至少 1 个月。(4) 大多数近期出现症状的颈动脉狭窄患者在症状出现后 14 天内进行颈动脉干预时，将获得最大益处。(5) 对于无症状的 60-99% 颈动脉狭窄的患者，有临床和/或更多影像学特征（对侧 TIA/卒中、同侧无症状梗死、经颅多普勒自发性栓塞、回声透明斑块、斑块内出血）可能与晚期同侧卒中风险增加有关，前提是记录的围手术期卒中/死亡率<3% 且患者的预期寿命超过 5 年。颈动脉支架置入术是手术的替代方案。(6) 对于患有肾动脉粥样硬化疾病的患者，由于不能改善血压、肾脏或心血管结局，因此不建议进行肾血运重建。除了少数例外，使用抗高血压药物、抗血小板药物、他汀类药物仍然是治疗肾动脉疾病患者的基石。(7) 慢性肢体威胁性缺血指定了与多种因素相关的脆弱肢体活力的临床模式。根据缺血、伤口和感染的严重程度对风险进行分层。早期识别组织损失和/或感染并将转诊给血管专家是保肢的必要条件。(8) 对于下肢动脉疾病 (LEAD) 患者，在做出治疗决定之前，应始终结合症状和血流动力学测试分析解剖成像测试的数据。(9) 多部位动脉疾病常见于一个血管床动脉粥样硬化受累的患者，范围从 CAD 患者的 10-15% 到严重颈动脉狭窄或 LEAD 患者的 60-70%。多部位动脉疾病总是与较差的临床结果相关。然而，尚未证明在其他血管部位筛查无症状疾病可以改善预后。(10) 除冠状动脉疾病外，其他心脏疾病如心力衰竭和心房颤动也很常见且具有预后意义。对于同时患有 AF 的稳定 PAD 患者，抗凝治疗是优先事项，并且在大多数情况下就足够了。对于近期血管内血运重建术，应根据出血和血栓形成风险考虑一段时间的联合治疗（抗凝+抗血小板治疗）。联合治疗的时间应尽可能短。尚未证明在其他血管部位筛查无症状疾病可以改善预后。(10) 除冠状动脉疾病外，其他心脏疾病如心力衰竭和心房颤动也很常见且具有预后意义。对于同时患有 AF 的稳定 PAD 患者，抗凝治疗是优先事项，并且在大多数情况下就足够了。对于近期血管内血运重建术，应根据出血和血栓形成风险考虑一段时间的联合治疗（抗凝+抗血小板治疗）。联合治疗的时间应尽可能短。尚未证明在其他血管部位筛查无症状疾病可以改善预后。(10) 除冠状动脉疾病外，其他心脏疾病如心力衰竭和心房颤动也很常见且具有预后意义。对于同时患有 AF 的稳定 PAD 患者，抗凝治疗是优先事项，并且在大多数情况下就足够了。对于近期血管内血运重建术，应根据出血和血栓形成风险考虑一段时间的联合治疗（抗凝+抗血小板治疗）。联合治疗的时间应尽可能短。在大多数情况下，抗凝治疗是优先事项并且就足够了。对于近期血管内血运重建术，应根据出血和血栓形成风险考虑一段时间的联合治疗（抗凝+抗血小板治疗）。联合治疗的时间应尽可能短。在大多数情况下，抗凝治疗是优先事项并且就足够了。对于近期血管内血运重建术，应根据出血和血栓形成风险考虑一段时间的联合治疗（抗凝+抗血小板治疗）。联合治疗的时间应尽可能短。