PERIPHERAL ARTERIAL DISEASE (PAD)
Patient Information Leaflet
What is Peripheral Arterial Disease?
Peripheral arterial disease (PAD) is a condition where the arteries that supply blood to your legs become narrowed or blocked. This happens because fatty deposits (plaque) build up inside the blood vessels, reducing blood flow to the muscles and skin.
When blood flow is reduced:
- Muscles do not receive enough oxygen
- Walking becomes painful
- Wounds heal slowly
- Tissue damage may occur
Common Symptoms
You may experience:
- Pain in the calf when walking (claudication)
- Pain in thigh or buttock when walking
- Pain relieved by rest
- Cold feet
- Numbness or tingling
- Slow-healing wounds
- Black toes or gangrene
- Rest pain (severe disease)
- Weak pulses in the foot
The pain usually gets worse with walking and improves with rest.
Risk Factors
You are more likely to develop PAD if you have:
- Smoking
- Diabetes
- High blood pressure
- High cholesterol
- Kidney disease
- Previous stroke or heart disease
- Age > 50 years
- Obesity
- Lack of exercise
Smoking is the biggest risk factor.
Why PAD is Important
PAD does not only affect the legs. It also increases the risk of:
- Heart attack
- Stroke
- Amputation
- Poor wound healing
- Limb loss
Tests You May Need
Your vascular specialist may request:
Blood Flow Tests
- Ankle Brachial Index (ABI)
- Segmental pressures
- Toe pressures
Imaging Tests
- Ultrasound Doppler
- CT Angiogram
- MR Angiogram
- Formal angiogram
These tests help determine:
- Where the blockage is
- How severe it is
- Best treatment option
Treatment Options
Treatment depends on severity.
Medical Treatment
This is recommended for all patients.
Lifestyle Changes
- Stop smoking
- Walk daily
- Control diabetes
- Control blood pressure
- Control cholesterol
- Weight loss
Walking improves circulation and symptoms.
Medications
You may be prescribed:
- Aspirin or Clopidogrel (blood thinners)
- Statins (cholesterol medication)
- Cilostazol (improves walking distance)
- Blood pressure medication
- Diabetes medication
These reduce risk of heart attack and stroke.
Angioplasty (Keyhole Procedure)
This is a minimally invasive procedure used to open blocked arteries.
During angioplasty:
- A small tube is inserted into artery (usually groin)
- A balloon is inflated to open the blockage
- A stent may be placed to keep artery open
- Blood flow improves
Benefits:
- Small incision
- Faster recovery
- Often same-day discharge
Risks:
- Bleeding
- Artery injury
- Re-blockage
- Kidney injury from dye
- Allergic reaction
- Blood clot formation
Bypass Surgery
This is open surgery used for long or severe blockages.
During bypass surgery:
- A vein or artificial graft is used
- Blood is rerouted around blocked artery
- Flow to foot improves
This surgery improves:
- Wound healing
- Pain
- Limb salvage
Risks include:
- Bleeding
- Infection
- Heart attack
- Stroke
- Graft blockage
- Poor wound healing
Amputation (When Necessary)
Amputation may be required when:
- Severe infection
- Gangrene
- Non-healing wounds
- No blood flow
- Failed revascularization
- Life-threatening sepsis
The goal is to:
- Remove diseased tissue
- Relieve pain
- Allow healing
- Preserve life
Risks include:
- Infection
- Poor healing
- Phantom pain
- Need for further amputation
When to Seek Urgent Help
Contact your doctor urgently if you develop:
- Sudden severe leg pain
- Cold pale foot
- Black toes
- Spreading infection
- Fever with foot wound
- Severe rest pain
- Loss of sensation
- Foot turning blue
These may indicate limb-threatening ischemia.
How You Can Help Yourself
You can improve circulation by:
✓ Stop smoking
✓ Walk daily
✓ Take medications
✓ Control diabetes
✓ Check feet daily
✓ Wear comfortable shoes
✓ Avoid foot injuries
✓ Keep feet warm
✓ Attend follow-ups
Foot Care Advice
Important for diabetic and PAD patients:
- Inspect feet daily
- Do not walk barefoot
- Cut nails carefully
- Moisturize dry skin
- Avoid hot water bottles
- Report wounds early
- Wear protective footwear
Follow-Up
Regular follow-up is important to:
- Monitor circulation
- Check wounds
- Adjust medication
- Detect re-blockage early
- Prevent amputation
Summary
Peripheral arterial disease reduces blood flow to the legs.
Treatment aims to:
- Reduce symptoms
- Improve walking
- Heal wounds
- Prevent amputation
- Reduce stroke and heart attack risk
Treatment may include:
- Medication
- Exercise
- Angioplasty
- Surgery
- Amputation (when necessary)
