Peripheral arterial disease (PAD) is a common circulatory problem in which narrowed arteries or blood clots reduce blood flow to your limbs. When you develop PAD, your extremities, usually your legs, don’t receive sufficient blood flow. Hardening of the arteries, in addition to increasing your risk of heart attack and stroke, also increases your risk of PAD.

Many Canadians do not seek treatment for chronic pain in their legs, hips or feet and think it to be part of getting older. Clogged arteries decrease blood supply to the legs, which can cause pain when walking (claudication), and eventually could even lead to pain at rest, gangrene and amputation (critical limb ischemia).

 The most common symptom of PAD is called intermittent claudication, which is painful cramping in the leg or hip that occurs when walking or exercising and typically disappears when the person stops the activity. Other symptoms include:

• Numbness, tingling and weakness in the lower legs and feet
• Burning or aching pain in feet or toes when resting
• Sore on leg or foot that won’t heal
• Cold legs or feet
• Color change in skin of legs or feet
• Loss of hair on legs
• Pain in the legs or feet that awakens you at night

Although PAD can happen at any age, those at highest risk are:

• Over age 50
• Smokers
• Diabetic
• Sedentary lifestyle
• High blood pressure
• Elevated cholesterol
• Have a family history of vascular disease, such as PAD, aneurysm, heart attack or stroke

The most common test for PAD is the ankle-brachial index (ABI). This is a painless exam that measures the ratio of blood pressure between the arms and feet. This exam can be performed at the specialized Mayfair Vascular Lab.  

Often PAD can be successfully managed through lifestyle changes, such as stopping smoking and a structured exercise program. Medications may also be prescribed to control high blood pressure and help lower cholesterol, control pain, or to prevent blood clots.

When more conservative treatments are not enough, interventional radiology procedures or surgical procedures may be appropriate:

• Angioplasty – Using image guidance, an interventional radiologist can pass a small catheter through the femoral artery and into the narrowed or blocked area. This catheter carries a balloon which is inflated to open the vessel, after which the balloon is removed. All of this is done through a tiny nick in the skin and you can go home a few hours later.
• Stenting – Sometimes balloon angioplasty is not enough, so the interventional radiologist may insert a small metal cylinder, called a stent, to help the vessel open back to its original size.

SAVI Radiologists work very closely with the Divisions of Vascular Surgery and Podiatry to ensure all patients receive a multidisciplinary approach to treatment. Referrals for critical limb ischemia and lifestyle limiting claudication should be sent to Vascular surgery and the Zivot Limb Preservation Clinic at the Peter Lougheed Hospital.