Mapping Risks: PAD Amputation Trends and New Insights into AFib-OSA Comorbidities

The PAD Collaborative has released a new interactive amputation map that reveals marked regional disparities in peripheral artery disease (PAD)–related lower-limb amputations, pinpointing geographic hotspots that could guide screening and referral priorities.

The PAD amputation map displays county- and district-level amputation rates and lets users filter by demographic and temporal variables. It highlights concentrated high-rate areas and emerging clusters over recent years, making it straightforward to identify local hotspots, track trends, and compare neighboring regions for differential risk. Clinically, the map’s granularity supports focused outreach and surveillance in neighborhoods with the highest five-year amputation incidence.

Geographic signals can reshape where health systems deploy ankle–brachial index (ABI) screening, mobile vascular clinics, patient education campaigns, and limb-preservation programs for maximal impact. Vascular surgery, primary care, wound care clinics, and community health teams should use these signals to adjust schedules and outreach lists. For example, a county with a rising amputation cluster could receive concentrated ABI screening, expedited vascular referrals, and targeted home-based wound checks. Using geographic precision to allocate resources can reduce preventable limb loss.

Obstructive sleep apnea (OSA) commonly co-occurs with atrial fibrillation (AFib); recognizing OSA in patients with AFib affects arrhythmia recurrence, symptom burden, and individualized risk stratification, although mechanistic links and optimal management pathways remain under study.

Clinicians can translate these combined insights into immediate actions: add high-rate geographic areas to outreach and screening registries, integrate targeted OSA screening questions or validated tools for patients with AFib, and predefine referral pathways to sleep medicine and vascular specialty services when dual risk is present. Multidisciplinary coordination—primary care initiating screening, vascular teams triaging ABI-positive patients, and sleep programs arranging expedited diagnostics—creates a practical pipeline that prioritizes patients most likely to benefit from early intervention.

Key Takeaways:

• The new map reveals regional PAD amputation hotspots and provides geographic precision to target interventions and surveillance.
• Patients in high-rate regions and the multidisciplinary teams managing PAD and AFib are most affected; coordinated screening and referral pathways are needed.
• Next steps: use mapping to focus screening and resources, screen AFib patients for OSA, and establish clear referral pathways to vascular and sleep specialists.