Peripheral Arterial Disease

What is peripheral arterial disease?

Peripheral arterial disease (PAD) is the narrowing or blockage of the arteries supplying the legs, most commonly from atherosclerosis. The classic symptom is claudication — a cramping ache in the calf, thigh or buttock that comes on with walking and eases with rest. As disease advances, pain can occur at rest, and wounds on the foot may fail to heal. This stage, critical limb ischaemia, threatens the limb itself.

Who is at risk?

Diabetes, smoking, high blood pressure, high cholesterol, kidney disease and age all raise the risk. In Singapore, diabetes-related PAD is a major cause of foot ulcers and amputation — most of which are preventable with timely vascular care.

How I assess it

Assessment combines a clinical examination with ankle-brachial pressure measurement and arterial duplex ultrasound, performed during your consultation. Where intervention is being planned, CT angiography maps the arteries in detail.

Treatment options

• Medical therapy and risk factor control — the foundation for every patient: antiplatelet therapy, cholesterol management, diabetes control and structured walking
• Angioplasty, atherectomy and stenting — reopening narrowed or blocked arteries from inside the vessel through a small puncture, often as a day procedure
• Bypass surgery — rerouting blood around long blockages where endovascular treatment is not suitable
• Wound care and diabetic foot management — protecting the foot while circulation is restored

When to seek help promptly

Foot pain at night relieved by hanging the leg down, a foot wound that is not healing within two weeks, or a cold, pale, painful foot are signs that need urgent vascular assessment.