Peripheral Arterial Disease

Peripheral Arterial Disease (PAD) is a condition where cholesterol deposition in the lining of the arteries to the legs causes narrowing of the arteries.

Understand your Problems

“I can barely walk for a distance, my legs are painful and I have to sit down for a while”

Have you experiencing pain at calf or foot on walking? It is more obvious after a long distance of walk. And the pain usually relieved after you stop and rest your legs. It is described as intermittent claudication, a common symptom of peripheral arterial disease.

 

Peripheral arterial disease happen when blood supply to leg muscles are restricted due to build up of cholesterol in the lining of the blood vessels. This leads to reduced blood flow and decreased blood supply to the peripheries.

 

In the initial phase of the disease, there are usually minimal symptoms. However, as the disease worsens, you may have pain even at rest or at night when sleeping. This is an indication for intervention to restore circulation to the legs. Failing to restore the circulation will put you at risk of losing the affected leg.

 

Seek for Treatments

The diagnosis of Peripheral Arterial Disease is made on the basis of the clinical history and physical examination of the patient, most importantly the palpation of pulses in the legs.

 

A duplex arterial scan is performed to demonstrate the location, extent and severity of narrowing of the arteries in the legs. This allows the vascular surgeon to assess which treatment modality is most suitable. The advantage of a duplex scan is that it is non-invasive and avoids radiation and contrast exposure. And this can be done at the bedside using a high-end ultrasound scanner during your consultation with our vascular surgeon, Dr Lee Chee Wei.

 

For patients with intermittent claudication, the mainstay of treatment is managing the risk factors, medications and supervised exercise therapy:

Risk factor managements
  • Control of blood glucose levels in diabetics
  • Control of blood pressure
  • Lowering low-density lipoprotein (LDL) and cholesterol levels
  • Diet and weight loss treatment
  • Smoking abstinence
Medications

Eg: Aspirin, Clopidogrel (Plavix), ticlopidine (Ticlid), Statins e.g. simvastatin, rosuvastatin (Crestor), atovarstatin (Lipitor)

Supervised Exercise Therapy
  • Exercise therapy encourages the formation of new blood vessels (collaterals) into the areas where there is inadequate blood supply.
  • A course of supervised exercise therapy by the physiotherapist has also been shown to significantly increase the walking distance in claudicants.

Patients with critical limb ischaemia require urgent evaluation by a vascular surgeon in order to salvage the leg that is threatened.

 

Treatment options for revascularization depends on many factors including the patient’s age and functional status, the extent and severity of disease, the availability of a suitable bypass conduit, etc. The options include: Bypass surgery, Balloon angioplasty, Angioplasty and stenting.

 

 

Arrange for consultation

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