Leg artery disease is also one of the more common arterial vascular conditions. If you have cramping when walking it may indicate leg artery problems, also called intermittent claudication. In more severe cases this can lead to pain, ulcers and gangrene, which needs urgent treatment.
In milder cases of claudication, we will often recommend observation and good risk-factor control of, for example, cholesterol, high blood pressure and diabetes control and stopping smoking. If walking becomes difficult, or when there is pain or ulcers, minimally invasive treatment is effective, for example, angioplasty and stent. Sometimes a patient will need an operation called arterial bypass.
All patients with leg artery narrowing caused by atherosclerosis should be on ‘best medical therapy’, ie, low-dose Aspirin, a statin and good blood pressure control. If you smoke, you need to give up.
Leg artery disease.
Consultation with Dr Richard Evans for leg artery disease.
Your treatment
If your problem is more severe we may recommend minimally invasive angioplasty or stent or possibly an arterial bypass operation if a minimally invasive treatment is not suitable. An angioplasty or stent is normally a day-case procedure under local anaesthetic, whereas a bypass operation usually requires a general anaesthetic and a hospital stay. Our nurse will be available before your procedure to answer any of your questions.
What is PAD?
Peripheral arterial disease (PAD) refers to diseased leg arteries. When cholesterol builds up in the leg arteries, it may cause narrowing and blockages in the arteries and, as a result, this may cause atherosclerosis. Impaired blood flow down the leg arteries may result in various symptoms and problems emerging.
Do I have PAD?
A degree of PAD is relatively common with ageing. This often does not cause any symptoms and, as a result, does not require any specific treatment, apart from maintaining a healthy lifestyle, exercising, weight control and good control of both high blood pressure and diabetes. Treatment is usually with low-dose Aspirin and a statin to control cholesterol. Stopping smoking is essential. In most cases, PAD does not progress rapidly and management is safe with simple monitoring.
When PAD does start to cause symptoms, a person may experience leg muscle pain with walking. Intermittent claudication is the usual term for this, meaning that it comes on with walking and stops with rest. When claudication becomes a real problem for someone, artery treatment is beneficial.
Calf muscle pain is common with PAD.
Ultrasound scan of leg arteries.
When is urgent treatment needed?
If PAD is severe, a patient may have pain all of the time but mostly at night (rest pain) and, additionally, they may have slow-healing ulcers or gangrene. This is a serious problem and with these sorts of symptoms urgent treatment is needed.
What investigations will I need?
Often the most simple investigation for PAD is an ultrasound scan of the leg arteries. This gives a clear picture of the problem and gives a good indication of what treatment will be needed.
More advanced investigations include CT scan, MRI scan, and angiogram.
What are my treatment options?
There are two main treatments for narrowed and blocked leg arteries caused by PAD.
Minimally invasive treatments include angioplasty and stent. These are day-case procedures using local anaesthetic. The aim is to widen a narrowed artery or to re-open a fully blocked artery, usually with a combination of high-pressure balloons and stents.
Bypass surgery is the next step when angioplasty and stent are not possible or have not been successful. This is an operation that puts a new artery in the leg, often using part of a patient’s own surface vein. Hospital stays after bypass surgery will usually be 3-7 days.
Stent Placement in a Narrowed Artery.