What is PAD?
Peripheral arterial disease (PAD) refers to diseased leg arteries. When cholesterol builds up in the leg arteries, it may cause narrowing and blockages in the arteries and, as a result, this may cause atherosclerosis. Impaired blood flow down the leg arteries may result in various symptoms and problems emerging.
Do I have PAD?
A degree of PAD is relatively common with ageing. This often does not cause any symptoms and, as a result, does not require any specific treatment, apart from maintaining a healthy lifestyle, exercising, weight control and good control of both high blood pressure and diabetes. Treatment is usually with low-dose Aspirin and a statin to control cholesterol. Stopping smoking is essential. In most cases, PAD does not progress rapidly and management is safe with simple monitoring.
When PAD does start to cause symptoms, a person may experience leg muscle pain with walking. Intermittent claudication is the usual term for this, meaning that it comes on with walking and stops with rest. When claudication becomes a real problem for someone, artery treatment is beneficial.
When is urgent treatment needed?
If PAD is severe, a patient may have pain all of the time but mostly at night (rest pain) and, additionally, they may have slow-healing ulcers or gangrene. This is a serious problem and with these sorts of symptoms urgent treatment is needed.
What investigations will I need?
Often the most simple investigation for PAD is an ultrasound scan of the leg arteries. This gives a clear picture of the problem and gives a good indication of what treatment will be needed.
More advanced investigations include CT scan, MRI scan, and angiogram.
What are my treatment options?
There are two main treatments for narrowed and blocked leg arteries caused by PAD.
Minimally invasive treatments include angioplasty and stent. These are day-case procedures using local anaesthetic. The aim is to widen a narrowed artery or to re-open a fully blocked artery, usually with a combination of high-pressure balloons and stents.
Bypass surgery is the next step when angioplasty and stent are not possible or have not been successful. This is an operation that puts a new artery in the leg, often using part of a patient’s own surface vein. Hospital stays after bypass surgery will usually be 3-7 days.
