Peripheral Arterial Disease

Patient Information Guide: Peripheral Arterial Disease

What is Peripheral Arterial Disease?

Peripheral arterial disease also known as PAD is a disease in which plague forms and blocks the arteries that carry blood to the head, limbs and other organs.

Eventually, the plague hardens and narrow the arteries, thereby reducing the flow of oxygen-rich blood to the organs. Plague is made up of fat, calcium, cholesterol, fibrous tissue and other substances in the blood.

Peripheral arterial disease frequently affects the arteries in the legs. It can also affect the arteries that carry blood from the heart to the head, arms, kidneys and stomach.

What cause PAD?

The primary cause of PAD is atherosclerosis, which is a buildup of plague in the arteries. The disease begins when the inner layers of the arteries get damaged by certain factors such as:

  • Smoking
  • Diabetes
  • High Cholesterol
  • High blood pressure

What are the Signs and Symptoms of PAD?

The typical symptom of PAD is pain in the legs, which occurs on walking or climbing stairs and is relieved by resting. However, nearly 40% of people with PAD do not experience leg pain. Symptoms of pain, ache, or cramp with walking may occur in the hip, buttock, thigh or calf.

Other signs and symptoms of PAD include sores or wounds on the feet, toes, or legs that heal slowly or may not heal, bluish discoloration of the skin, reduced temperature of the affected leg compared to the other leg and poor nail growth on the toes of affected leg.

What are the Treatment Options Available for PAD?

The treatment of PAD focuses on reducing symptoms, improving quality of life and preventing complications. The therapeutic options include lifestyle modifications, medications and surgical procedures.

Lifestyle modifications:

  • Quit smoking: The risk of PAD increases four times with smoking.
  • Reduce high blood pressure
  • Reduce high cholesterol levels
  • Reduce blood sugar levels if diabetic


Doctor may prescribe medications to:

  • Treat high cholesterol levels and high blood pressure
  • Prevent the formation of blood clots due to reduced blood flow
  • Reduce leg pain during walking or climbing stairs

Surgical procedures

  • Bypass grafting: In this procedure, a blood vessel from another part of the body or artificial tube resembling blood vessel is used to make a graft. This graft is used to bypass the blocked part of the blood vessel. The bypass allows blood to flow around the blockage.
  • Angioplasty and stenting: In this procedure, a thin tube called catheter with a balloon at the tip is inserted into a blocked blood vessel. The balloon is then inflated there by pushing the plague outward against the wall of blood vessel. This increases the area of the blood vessel and maintains blood flow. A stent is a small mesh tube inserted during angioplasty. It helps to keep the blood vessel open after angioplasty.
  • Atherectomy: In this procedure, the plague build up is removed from the blood vessel by inserting a small cutting device. The bits of plague are removed from the body via catheter.

How can PAD be prevented?

Controlling the risk factors for PAD can help prevent or delay the disease and its complications. The lifestyle modifications described above can also help prevent or delay PAD.


  1. Peripheral Arterial Disease. [Online]
    Available at:
    [Accessed 4 February 2015].
  2. Peripheral Arterial Disease (PAD) Fact Sheet. [Online]
    Available at:
    [Accessed 4 February 2015].

Our Doctor

Dr Syaiful Azzam bin Sopandi

Consultant General & Vascular Surgeon
General Surgery, Vascular Surgery