Peripheral Arterial Disease (PAD)

What Is PAD?

Peripheral Arterial Disease (PAD) is a common condition in which the arteries supplying blood to the legs become narrowed or blocked due to a build-up of fatty deposits, known as plaque (atherosclerosis). This reduces blood flow to the muscles and tissues of the lower limbs.

The most common symptom of PAD is claudication, which presents as:

• Cramping or aching pain in the legs during walking or exercise

• Relief of symptoms with rest

This occurs because the muscles are not receiving enough oxygen-rich blood during activity.

If left untreated, PAD can progress and increase the risk of:

• Non-healing leg or foot ulcers

• Infection

• Reduced mobility

In severe cases, tissue damage

Diagnosis & Assessment

A thorough clinical assessment is essential for diagnosing PAD. This may include:

• Physical Examination

• Ankle-Brachial Index (ABI): A simple, non-invasive test comparing blood pressure in the arms and legs

• Vascular Ultrasound: To assess blood flow and identify areas of narrowing or blockage

Treatment Options

Treatment depends on the severity of the condition and is focused on improving blood flow, relieving symptoms, and preventing progression.

Conservative & Medical Management

In the early stages, treatment may include lifestyle modification, exercise programmes, and medications to improve circulation and reduce cardiovascular risk.

Endovascular Treatments

Angioplasty

Angioplasty is a minimally invasive procedure used to widen narrowed or blocked arteries.

• A small balloon is inserted into the affected artery

• The balloon is inflated to compress plaque against the artery wall

• This restores and improves blood flow

In some cases, a stent (a small mesh tube) may be inserted to help keep the artery open and reduce the risk of re-narrowing.

Surgical Treatment

Peripheral Artery Bypass Surgery

For more advanced PAD, surgery may be required to restore adequate blood flow.

This procedure involves creating a bypass (detour) around the blocked section of the artery using a graft. The graft may be:

• A vein taken from another part of your body (commonly the leg)

• A synthetic material

How the procedure works:

• The patient is given anaesthesia for comfort

• An incision is made to access the affected artery

• A graft is attached above and below the blockage

• Blood flow is redirected through the graft, bypassing the narrowed segment

• The incision is closed and dressed

Recovery & Outcomes

Peripheral artery bypass surgery can significantly improve:

• Leg pain and walking distance

• Overall circulation

• Quality of life

It also helps reduce the risk of serious complications, including tissue damage and limb loss.

Patients may require a short hospital stay following surgery, along with ongoing follow-up to monitor recovery and ensure the graft remains functioning effectively.