Contributors: EA participated in the literature search and writing and editing the article. NAM participated in writing and editing the article and sourced the patient photographs. FP participated in writing and editing the article. PAC participated in the literature search and editing the article and was responsible for overall supervision of the study; he is guarantor for the study. Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: PAC received travel expenses from Bayer to present on peripheral arterial disease to a general audience of primary and secondary care at the RCP.