Vascular
Peripheral Artery Disease
A circulatory problem in which narrowed arteries reduce blood flow to your limbs, usually causing leg pain.
Peripheral artery disease (PAD) involves narrowing of leg arteries due to atherosclerosis, resulting in leg pain during walking, slow-healing wounds, and in severe cases, critical limb ischaemia. The condition also signals broader cardiovascular disease risk throughout the body.
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Peripheral artery disease occurs when plaque buildup narrows the arteries, restricting blood flow to the legs and causing pain during physical activity.
Symptoms
- Intermittent claudication: calf, thigh, or buttock pain triggered by walking
- Rest pain: burning or aching foot sensations, especially at night
- Cold or pale feet with absent pulses
- Non-healing ulcers and gangrene in advanced stages
- Erectile dysfunction in men
Risk Factors
- Smoking (fourfold increased PAD risk; worse intervention outcomes)
- Diabetes, hypertension, high cholesterol
- Obesity and advancing age
Diagnosis
- Ankle-brachial index (ABI) testing
- Duplex arterial ultrasound for lesion mapping
- CT or MR angiography for detailed vessel visualisation
- Toe-brachial index for calcified vessel assessment
Treatment Options
- Cardiovascular risk factor modification and smoking cessation
- Antiplatelet therapy and high-intensity statin use
- Supervised exercise therapy (most evidence-based intervention for claudication)
- Endovascular revascularisation: angioplasty, stenting, atherectomy
- Surgical bypass for lifestyle-limiting claudication and critical limb ischaemia
Concerned About Peripheral Artery Disease?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.