2025年美国血管外科学会《间歇性跛行临床实践指南（更新版）》解读

doi:10.3969/j.issn.1006-5725.2026.09.001

摘要/Abstract

摘要：

2025年美国血管外科学会（SVS）在《Journal of Vascular Surgery》上发布了其对2015版间歇性跛行（IC）管理指南的首次重点更新。更新指南围绕六大PICO问题提出12条推荐，其中包括2项最佳实践声明，更新指南首次将低剂量利伐沙班纳入IC管理路径，强化了运动及药物治疗的一线策略地位，并对血运重建的适用情形、胫动脉介入治疗以及药物涂层器械的应用提出了更为慎重的意见。本文依据最新的指南原文，对其核心更新进行系统阐释，着重剖析各项建议的推荐强度与证据等级，从而为血管外科医师构建一个实用的临床决策参考框架。

关键词: 间歇性跛行, 抗栓治疗, 运动治疗, 血运重建, 临床实践指南

Abstract:

In 2025， the American Society of Vascular Surgery （SVS） released its first focused update on the 2015 management guidelines for intermittent claudication （IC） in the Journal of Vascular Surgery. This updated guideline set is structured around six key PICO questions， leading to twelve evidence-based recommendations， including two best-practice statements. Significantly， this update is notable because it represents the first incorporation of low-dose rivaroxaban into the management pathway for IC， highlighting the significance of both exercise therapy and pharmacologic treatment as primary strategies. Moreover， the guidelines take a more prudent approach towards indications for revascularization， tibial artery interventions， and the use of drug-coated devices. This article systematically interprets the core updates from the latest guideline text， concentrating on analyzing the strength of the recommendations and the level of evidence backing each suggestion. The objective is to establish a practical framework for clinical decision-making to aid vascular surgeons in their clinical practice.

Key words: intermittent claudication, antithrombotic therapy, exercise therapy, revascularization, clinical practice guideline

中图分类号:

R543.5

曹华燕,陈松伟,李强. 2025年美国血管外科学会《间歇性跛行临床实践指南（更新版）》解读[J]. 实用医学杂志, 2026, 42(9): 1485-1490.

Huayan CAO,Songwei CHEN,Qiang LI. Interpretation of the 2025 Society for Vascular Surgery Clinical Practice Guideline Update for Intermittent Claudication[J]. The Journal of Practical Medicine, 2026, 42(9): 1485-1490.

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