Atherosclerotic Peripheral Vascular Disease Symposium II

It has been proposed that vascular screening programs should be widely established to provide earlier detection of peripheral artery disease, carotid artery disease, renal artery disease, and abdominal aortic aneurysms (AAAs) to diminish the societal burden of these illnesses. Early detection of these conditions could lead to treatments that offer the potential to reduce the incidence of fatal and nonfatal myocardial infarction (MI) and stroke, death due to AAA rupture, and renal failure, as well as to improve quality of life. These goals engender considerable enthusiasm. There are many reasons to propose a broad, populationbased approach to establishment of vascular screening programs. Each arterial disorder is asymptomatic for a prolonged length of time, during which detection might be effective, defining a proposed “detection gap”1; diagnostic tools are available that are accurate, safe, and relatively cost-effective; the database has improved overall such that these diagnostic methods could theoretically be applied selectively to targeted “at-risk” populations; and the publication of consensus-driven treatment guidelines now fosters use of effective treatments, while restraining the use of harmful or unproven treatments.2 Thus, it might be feasible to detect preclinical atherosclerosis and stenotic or aneurysmal disease in screening programs applied to specific at-risk populations with achievable benefits and minimal harm.