The Journal of Endovascular Therapy (JEVT) has announced the publication of the latest update of the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II), an internationally recognised set of guidelines for the management of patients with peripheral arterial disease.
Originally published in 2000, the TASC document represents the collaboration of international vascular specialties involved in the treatment of peripheral arterial disease patients. One highly utilised aspect of the TASC guidelines is the TASC anatomical artery lesion classification (A-D), which characterises the various patterns of disease and provides guidance on treatment decisions regarding the optimal revascularisation strategy (endovascular vs. surgical). The TASC II guidelines published in 2007 included a revision of the original TASC classification for peripheral arterial disease patients, with a focus on the aortoiliac and femoropopliteal territories.
“In this update, the classification of disease is extended to involve the below the knee arteries as well. This [Not addressing this anatomical region] was a shortfall of TASC-I and II. In future updates, the hope is to further refine the classification and add recommendations as more data becomes available,” Mahmood K Razavi, an interventional radiologist from Orange County, USA, and one of the authors on the paper in JEVT told Interventional News.
Since the publication of the TASC II document, a number of scientific publications and observational reports have documented the rapid adoption of endovascular therapy as a primary strategy for the treatment of symptomatic peripheral arterial disease patients. The overall result is that there has been an increase in the adoption of the endovascular-first strategy for even the most complex anatomies. This shift was not clearly reflected in TASC II. In addition, the TASC II lesion classification did not include the infrapopliteal arteries, which was an important omission given today’s expanding technologies and techniques for catheter-based tibial and distal interventions for patients with critical limb ischemia. Thus, the focus of the TASC II supplement published today in the JEVT is to update the endovascular and surgical revascularisation strategies and techniques for PAD and to expand the TASC lesion classification to include below-the-knee arteries. The document has been prepared in relationship with a number of vascular societies worldwide and has been endorsed by the ISES.
According to George A Antoniou of the Royal Liverpool University Hospital, whose commentary accompanies the TASC II supplement, “The treatment of peripheral arterial disease patients has seen dramatic evolutionary changes over the past decade. Updates of literature, techniques, and practices by expert committees are an essential tool to facilitate and guide clinical practice.” Given the worldwide importance of this TASC II supplement, the article is being co-published with permission of the authors and SAGE in the following journals: Vascular Medicine, Catheterization and Cardiovascular Interventions, Annals of Vascular Diseases, Journal of the Japanese College of Angiology (Japanese translation), and Técnicas Endovasculares (Spanish translation).