Peripheral arterial disease (PAD) |
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Atherosclerosis The most common arteries
to be involved :- |
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- legs (causing cramps when walking, known as claudication),
- carotid arteries (causing strokes) and
- the arteries to the kidneys (causing high blood pressure).
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| Diabetic patient
with critical limb ischemia |
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Peripheral Angioplasty as the First-choice Revascularization Procedure in Diabetic Patients with Critical Limb Ischemia.
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Thrombus / embolic critical limb ischemia |
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An acute limb ischemia due to thrombus.
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Blockage in the arteries supplying the
legs can result in: |
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Pain, cramp, or tightness in the calves, thighs, hips or buttocks when walking, which is relieved with a few moments rest (also known as intermittent claudication)
in severe cases, pain occurring at night or at rest, which is often relieved only when the leg is hung over the edge of the bed or placed on a foot stool
skin ulcers (sores) or gangrene (dead tissue)
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Blockage that occurs suddenly can result
in more severe symptoms in the arm or leg. These include: |
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sudden pain
paleness or whiteness
no pulse
numbness or tingling
coolness in one leg when the other leg is warm
paralysis (inability to move)
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Typical sites of blockages of the arteries: |
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An ischaemic foot which is purplish, cold and painful |

A typical vascular ulcer
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Due to its invasive nature bypass surgery does carry a :-
- high incidence of mortality and morbidity.
- Restenosis and embolisms are relatively common.
- Expensive.
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Endovascular procedures are becoming more
popular. |
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- It reduced morbidity compared to bypass,
- cost-effective
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Over the past 20 years angioplasty and / or stenting has replaced bypass as the initial treatment of choice |
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Right Lower Limb Angiography with marked stenosis of distal SFA |
Post angioplasty angiogram |
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Limb threatening ischemia |
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54 / Male
- Period of 2 weeks, leg become purple, cold with severe pain and sweeling
Angiogram shows anterior tibial artery & severe focal stenoses of the TP trunk and posterior tibial artery.
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Pre angioplasty angiogram |
Post angioplasty angiogram |
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60/Male, An Acute onset of-
- sever pain in left leg
- colour become purple and
- cold
Diagnostic Angiogram shows an acute thrombus
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Post angioplasty Angiogram
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