25 Questions and Answers
PAD occurs when cholesterol and fatty deposits build up on the inner walls of the arteries that carry blood from the heart to the leg muscles, causing them to narrow or become blocked. Atherosclerosis is the most common cause. When blood flow is reduced, pain, coldness, and colour changes appear during walking. In advanced stages, tissue death and non-healing wounds can develop.
Typical symptoms include cramping or pain in the calves while walking that eases with rest, coldness in the leg, slow nail growth, hair loss on the leg, and wounds that are slow to heal. If pain persists even at rest, the disease is in an advanced stage and urgent evaluation is required.
PAD is more common in smokers, people with diabetes or high cholesterol, those with hypertension or obesity, and men over 50. People with heart disease or carotid artery disease also have a high rate of coexisting PAD.
Reduced blood flow means muscles do not receive enough oxygen. This causes a condition called claudication. The pain eases with rest and returns when walking resumes. It is considered an early warning sign.
Diagnosis begins with the ankle-brachial index (ABI) measurement. Doppler ultrasound, CT angiography, or MR angiography may follow. These methods clearly determine the location and severity of the blockage. Conventional angiography is used when necessary.
The first step is lifestyle modification: quitting smoking, exercising, and controlling cholesterol and blood sugar. Medications (blood thinners, statins) are started. In advanced cases, balloon angioplasty, stenting, or bypass surgery is performed.
No. For mild to moderate narrowing, medication and walking therapy may be sufficient. However, if rest pain or wounds are present, or if the artery is completely blocked, surgery is essential.
A stent is a metal tube placed in the narrowed area to restore blood flow. A bypass creates a vascular bridge around the blockage to reroute blood. The decision depends on the length of the blockage and the patient's overall condition.
Yes — slow-paced walking promotes the development of new vascular pathways (collaterals) that carry oxygen to the muscles. Regular walking raises the pain threshold and slows disease progression. However, its benefit is reduced if the patient continues to smoke.
It is the single most important treatment step. Smoking accelerates atherosclerosis and reduces the success of stents and bypass surgery. Vascular function begins to improve as soon as smoking stops.
High blood sugar damages the vessel wall and increases clotting risk. In diabetics, blockages occur at a younger age and in both legs. Good blood sugar control reduces the risk of wounds and amputation.
A Mediterranean-style diet is recommended: olive oil, fish, vegetables, whole grains, low salt, low sugar. Red meat, butter, and processed foods should be avoided. Drink plenty of water and maintain a healthy weight.
When rest pain, wounds, or blackening of the toes appears, the disease is in an advanced stage. Blood flow has dropped to a critical level and urgent intervention is needed; otherwise, limb loss may occur.
Progressive arterial blockage causes irreversible tissue damage. Wounds open, infection develops, and amputation may be required. The risk of heart attack and stroke also increases.
Yes, particularly after menopause when oestrogen levels decline, the risk rises. The use of oral contraceptives combined with smoking increases the risk further.
In cold weather, blood vessels constrict, making it even harder for blood to pass through already narrowed arteries. Pain may worsen during winter months. Keeping the legs warm is important.
Yes, if risk factors are not controlled. Re-narrowing (restenosis) is common in patients who continue to smoke. Regular check-ups are essential.
A hospital stay of a few days is usually required. Wound care and walking rehabilitation are important. Medications must be taken regularly and follow-up appointments must not be missed.
Do not wait for it to heal on its own. Without restoring blood flow, the wound will not heal and infection risk increases. A cardiovascular surgeon should be consulted urgently.
In most cases, yes — with early diagnosis. Revascularisation procedures and oxygen therapy can save the limb. If treatment is delayed, tissue death becomes unavoidable.
Every 3–6 months after a new diagnosis and annually during stable periods with Doppler ultrasound. If symptoms worsen, an appointment should be made without delay.
In a lying position, the effect of gravity is reduced and less blood reaches the legs. This is why pain becomes more pronounced at night. Letting the foot hang slightly downward provides temporary relief.
Seated leg movements, pedalling exercises, and ankle exercises can be performed under the guidance of a physiotherapist. Always start with a doctor's approval.
Yes, both conditions stem from atherosclerosis. If there is arterial blockage in the legs, there is a high likelihood of problems in the heart and brain arteries as well.
Quit smoking, maintain an ideal weight, keep blood pressure and blood sugar balanced, walk regularly, and meet cholesterol targets. An annual vascular check-up can be life-saving.
