Editorial Lower extremity arterial disease – call for a standardized and comprehensive name of the disease to improve public awareness Comment on Bauersachs et al., pp. 294–300 Salah D. Qanadli and David Rotzinger Cardio-Thoracic and Vascular Unit, Department of Radiology, University Hospital of Lausanne, Switzerland We read with great interest the article published by Bauersachs et al. [1] reporting interesting results from a self- reporting survey conducted in nine countries measuring public awareness about peripheral arterial disease (PAD). Unsurprisingly, only 34% of participants associated PAD with arms and legs, and the heart was associated with PAD in 48%. Furthermore, participants who declared to be “very” or “moderately” familiar with PAD associated the heart with PAD in 25% while arms and legs were associated with PAD in only 22%. We fully agree with the authors’ conclu- sions that there is an obvious knowledge gap regarding PAD, and measures dedicated to improve public awareness are urgently needed. Patient awareness is crucial not only for improving patient management but also for building efficient preventive programs and health campaigns. On the other hand, we believe that one key reason for the lack of public perception of the disease has not been thoroughly addressed in this article, despite efforts under- taken to provide sufficient explanations, including cultural variations between countries. Since the disease itself is poorly defined and professionals have so many different wordings designating the same disease, no one could expect a significant improvement in how the disease is identified or perceived by the public and even patients. Looking at the most popular references, we can read (Wikipedia) [2] that PAD is “an abnormal narrowing of arteries other than those that supply the heart and the brain”. From this point of view, PAD refers exclusively to obstructive vascular disease, involving not only legs and arms but also visceral arteries (renovascular disease and mesenteric arteries for example). Unfortunately, professional societies have not provided more clarity until now. For instance, the American Heart Association (heart.org) [3] defines PAD as “an abnormal narrowing of arteries to the legs, stomach, arms and head” while the Society of Vascular Surgery [4] restricted the def- inition to arteries of the legs. The term “peripheral” refers to what is not “central”, which is the most straightforward manner to distinguish coronary artery disease (“central”) from the rest (“peripheral”). This simplified way of communication likely served its purpose in the last century. However, challenges and approaches of modern patient management and future developments in predictive and preventive medicine [5] require standardizing terminology and nosological entities as much as possible. This standardization should also aim to be transparent and understandable by the public to ensure that messages are easily perceived. David S. Slawson reported that “Anthropologists recognize naming as one of the chief methods for imposing order on perception. What is not named in a culture very likely goes unnoticed by the majority of its people”. We believe that the term “lower extremity arterial disease” (LEAD) is sufficiently precise and efficiently supports future communication about the disease. For those reasons, clearly supported by the authors’ findings, we believe it is now time to call for a standardized and comprehensive name denoting the lower extremity arterial disease. References 1. Bauersachs R, Brodmann M, Clark C, et al. International public awareness of peripheral artery disease. VASA. 2021;50(4):294–300. 2. https://en.wikipedia.org/wiki/Peripheral_artery_disease 3. https://www.heart.org/en/health-topics/peripheral-artery-disease 4. https://vascular.org/patient-resources/vascular-conditions/ peripheral-arterial-disease 5. Qanadli SD. Research in vascular medicine: where we are and where we are going. Front Cardiovasc Med. 2020;7:45. Conflicts of Interests No conflicts of interest exist. Correspondence address Salah D. Qanadli, MD, PhD, MBA Cardio-Thoracic and Vascular Unit Department of Radiology Rue du Bugnon 46 1011 Lausanne Switzerland salah.qanadli@chuv.ch Ó 2021 Hogrefe Vasa (2021), 50 (4), 249 https://doi.org/10.1024/0301-1526/a000952 249 https://econtent.hogrefe.com/doi/pdf/10.1024/0301-1526/a000952 - Wednesday, January 04, 2023 3:48:25 PM - IP Address:34.235.114.76