Diabetes
Smoking
Hypertension
High cholesterol levels
Old age
Thrombophilia (hypercoagulable state)
Pain in calf or thigh upon walking is the first symptom of PAD.
It occurs at a similar distance of the leg and is relieved on rest.
It may be misunderstood as joint pain or muscle pain.
If this disease progresses, patients develop ulcers in foot with severe pain even at rest.
They may be unable to sleep due to this pain.
Eventually, gangrene or blackening of skin or toes develops and patients may require amputation.
Color Doppler
CT angiography
Angiography
Not all patients require major surgery if diagnosed in time. Certain medicines are useful along with control of risk factors like smoking, diabetes, hypertension and high cholesterol.
Useful for improving claudication and thus walking distance. But this may not be suitable for patients who have ulcer or gangrene.
Minimally invasive techniques through needle punctures and utilizing endovascular balloons or stents have revolutionized the treatment of PAD. There have been substantial developments in the skills and resources utilized for endovascular procedures over the past decade. Continuously upgrading expertise has led to the development of drug coated balloons, atherectomy devices and vascular mimetic stents, which promise to deliver better results than previous devices.
Often, long segment blockages or multilevel blockages are better dealt with by surgical bypass. Surgical bypass can be performed by using patient's own vein or a synthetic graft and can be performed from the abdomen to the foot depending on the level and extent of arterial blockage.
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