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What is Peripheral Arterial Disease ?

Your arteries carry blood that is rich in oxygen and nutrients from your heart to the rest of your body. When these arteries in your legs get blocked, your legs do not receive enough blood or oxygen, and you may have a condition called Peripheral Arterial Disease (PAD)

What are the symptoms of lower limb PAD ?

In early stages of the disease, that is when artery is partially blocked it would cause pain in your legs while you walk, but in late stages it could give rise to a non-healing ulcer in the foot, blackish discoloration of your toes or would cause severe pain even at rest more so at night.

What are the complications of having a PAD ?

If you are a Diabetic with PAD then there is a 25% risk of a major amputation and in patients who are non-diabetic risk of a major amputation is 5%.
When should I seek a medical opinion if I have symptoms of PAD ?

If you are a diabetic it is advised after the age of 50, you should have an annual screening to rule out any Peripheral Vascular Disease (PAD).

If you have any symptoms like aching in your legs, Discoloration of your toes, Coldness of your feet of any ulcer that does not heal it is advisable that you should seek an expert opinion to rule out any serious PAD in your lower limbs.

What test would be done for me at the clinic ?

Apart from basic blood tests you would be seen by a vascular technician in the vascular lab. In the lab you would be subjected to a small test to assess any decrease in blood flow to your foot by checking the blood pressure in your legs which is called Ankle Brachial Pressure Index (ABI).

Then you may be advised to undergo an ultrasound scan of your blood vessels by a radiologist to look for any blocks in the blood circulation of your leg.

If we feel that you would need some treatment for your PAD then you may have to undergo and test called angiogram where a dye would be injected in to your arteries to assess the blocks that you might have in them.
What are the treatment options available ?

In early stages of disease when you have only pain during walking you may be advised to do the following

1 Stop Smoking
2 Control your Diabetes
3 Control your blood cholesterol levels
4 You would be advised to take some medications to improve blood supply (You must remember that these medications would not clear the blocks that have already developed in your blood vessels and you must be under follow-up of your doctor while you are on these medications)
5 Walking exercises as advised and care of your feet.

What are the Other treatment options ?

If you have limb threatening limb ischemia or if your symptoms do not improve with above measures then you will have to undergo some procedures which would correct the block in your arteries. There are broadly 2 types of treatment

Balloon Angioplasty: Here blocks in your artery is corrected by breaking through the block with a balloon which is placed in the diseased artery through a small pin prick in your groin.

Limb Bypass Surgery: In patients who are not suitable for Balloon angioplasty a bypass operation is done to get the blood below the blocked segment of the artery from a healthy segment above