Peripheral arterial disease is a narrowing, hardening or blockage of the main blood vessels in the legs. It reduces the blood and oxygen flow to your leg, which can result in aching or tightness in the calf or thigh muscles during walking; this is called intermittent claudication. With or without symptoms it increases the risk of a heart attack and stroke and in extreme cases leg amputation.
How does it present in the foot?
- The foot maybe cold to touch and pale, pain on walking and resting.
- Leg and foot ulcers that have failed to heal, thinning of the skin and muscle wastage in the forefoot.
- The symptoms maybe different in each foot and may be masked due to medication or a lack of exercise.
20% of leg and foot ulcers are due to arterial disease
What increases the risks of PAD?
- Increase in Blood Pressure and Cholesterol.
- Poor control of Diabetes.
- Lack of exercise and overweight, BMI over 30
Can it be successfully treated?
What does an assessment involve?
- History and symptoms are recorded.
- The circulation to the feet and leg is initially assessed by the podiatrist by checking the pulses with a Doppler ultrasound.
- In addition the ankle brachial pressure index( ABPI) can be calculated from the systolic pressure of the arm and then the pressure of the ankle, the foot score is divided by the arm score and the results determine whether there is a problem with the circulation.
- Toe pressure can be taken if the ankle is swollen.
- Temperature of the foot is recorded.
- Capillary refill time in the toes is checked by a Buerger’s test exercise.
- Based on the results of the test, a copy can be sent to your GP with the appropriate treatment recommendations.
- Some patients may need a referral to a vascular surgeon for further assessment and treatment.
How long does the test take?
Approximately an hour as usually done alongside a Diabetic and Neurological assessment. You are required to lie still during the assessment, none of the procedures are painful. Please wear loose clothing to the assessment.