Peripheral arterial disease (PAD) is a significant yet often overlooked vascular condition that affects millions worldwide. This disease results from the narrowing or blockage of arteries, primarily in the legs, due to the accumulation of fatty deposits (atherosclerosis). PAD not only restricts mobility but can also lead to severe complications, including ulcers, infections, and in extreme cases, limb amputation.
At Northern Heart Hospital, Assoc Prof Edward Choke, a senior consultant in vascular surgery, leads the charge in offering minimally invasive treatments for PAD. With his extensive expertise and access to state-of-the-art facilities, Dr Choke ensures each patient receives world-class care tailored to their needs.
What is Peripheral Arterial Disease (PAD)?
Peripheral arterial disease (PAD) is a chronic circulatory condition caused by the narrowing or blockage of peripheral arteries, which supply blood to the limbs. The root cause is often atherosclerosis—a build-up of fatty deposits, or plaques, within the arterial walls. This progressive narrowing reduces oxygenated blood flow to the muscles and tissues of the legs and feet, leading to discomfort and, in advanced cases, serious complications.
PAD is most commonly associated with older adults, smokers, and those with chronic conditions like diabetes, hypertension, or high cholesterol. However, it can occur in younger individuals, especially if they have a family history of vascular disease or lead a sedentary lifestyle.
Symptoms of PAD
The early signs of PAD are subtle and may be mistaken for general fatigue or muscle strain. Symptoms tend to worsen over time if left untreated and may include:
- Claudication: Pain, cramping, or fatigue in the legs or hips during walking or exercise, relieved by rest.
- Leg weakness or numbness: A feeling of heaviness or tingling in the lower limbs.
- Cold sensation in the feet or legs: Especially when compared to the opposite limb.
- Changes in skin texture or colour: Shiny, smooth skin or a dusky appearance.
- Sores, ulcers, or wounds: Slow-healing wounds, particularly on the toes or feet, can indicate reduced blood flow.
In severe cases, PAD may cause critical limb ischaemia (CLI), a condition characterised by severe pain, gangrene, or tissue death due to inadequate blood supply. CLI is a medical emergency requiring immediate treatment to save the limb.
How is PAD Diagnosed?
Early detection of PAD is crucial for effective management and to prevent complications. At Northern Heart Hospital, Assoc Prof Edward Choke employs a comprehensive and patient-centred diagnostic approach, leveraging advanced technology for precision.
Common diagnostic tools include:
- Ankle-Brachial Index (ABI):
This simple, non-invasive test measures the blood pressure in the ankles and compares it to the pressure in the arms. A significantly lower reading in the ankles suggests poor blood flow, an early sign of PAD. - Doppler Ultrasound:
This imaging technique uses sound waves to assess blood flow through arteries and detect areas of narrowing or blockages. It’s a painless and effective way to visualise the vascular system. - CT or MR Angiography:
These advanced imaging methods use contrast dyes and X-rays or magnetic resonance to create detailed images of blood vessels. They help pinpoint the severity and location of blockages, aiding in treatment planning. - Treadmill Test:
In some cases, a supervised walking test is performed to observe symptoms such as pain or fatigue under controlled conditions.
By combining these diagnostic tools with a thorough clinical examination, Dr Choke ensures a precise and accurate diagnosis, setting the stage for targeted treatment.
Preventing Peripheral Arterial Disease
Preventing PAD requires a proactive approach to maintaining arterial health. Lifestyle changes and managing underlying conditions can significantly reduce the risk of developing or worsening PAD.
Key Prevention Strategies:
- Quit smoking: Smoking is one of the most significant risk factors for PAD, as it damages arterial walls and promotes plaque build-up. Quitting smoking dramatically improves vascular health.
- Adopt regular physical activity: Walking, swimming, or cycling enhances circulation and strengthens cardiovascular health. Even moderate exercise, such as brisk walking for 30 minutes daily, can help.
- Eat a heart-healthy diet: A diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats (e.g., olive oil) supports overall vascular health. Limiting saturated fats, trans fats, and excess sodium is equally important.
- Control chronic conditions: Proper management of diabetes, high blood pressure, and cholesterol levels is vital. Regular monitoring and adherence to prescribed medications can prevent vascular complications.
- Maintain a healthy weight: Excess weight places additional stress on the vascular system, contributing to arterial narrowing.
Regular check-ups with a vascular specialist, especially for high-risk individuals, can also help in early detection and timely intervention.
Minimally Invasive Treatments for PAD
Recent advancements in medical technology have revolutionised the treatment of PAD, offering minimally invasive procedures that are effective, safe, and require shorter recovery times. Dr Edward Choke is a leading expert in these techniques, providing personalised care to achieve the best possible outcomes for patients.
Minimally invasive options include:
- Angioplasty and Stenting:
In this procedure, a small balloon is inserted into the narrowed artery and inflated to widen it. To ensure long-term success, a stent (a tiny mesh tube) may be placed to keep the artery open. This treatment is highly effective for restoring blood flow and alleviating symptoms like claudication. - Atherectomy:
This technique involves using a specialised catheter to remove plaque build-up from the arterial walls. It is particularly useful for patients with heavily calcified or complex lesions that may not respond to other treatments. - Drug-Coated Balloon (DCB) Therapy:
A novel approach in PAD management, DCB angioplasty uses balloons coated with medication (e.g., sirolimus or paclitaxel) that are released during the procedure to prevent re-narrowing of the artery. - Endovascular Thrombectomy:
In cases where blood clots block the arteries, this procedure uses advanced tools to extract the clot and restore circulation. This minimally invasive approach is critical for acute limb ischaemia. - Hybrid Procedures:
Some patients may benefit from a combination of endovascular and open surgery. The hybrid operating theatre at Northern Heart Hospital is equipped to perform both techniques seamlessly, ensuring optimal results.
Advantages of minimally invasive techniques:
- Shorter hospital stays
- Faster recovery times
- Reduced risk of infection and complications
- Minimal scarring
These procedures are performed in state-of-the-art facilities at Northern Heart Hospital, ensuring that patients receive the highest quality care. With Dr Choke’s expertise, patients can regain mobility and significantly improve their quality of life.
Why Choose Northern Heart Hospital?
The Vascular and Endovascular Surgery Service at Northern Heart Hospital is a dedicated unit offering a comprehensive range of treatments for vascular diseases. Led by specialists like Assoc Prof Edward Choke, the team integrates clinical expertise, innovative techniques, and a multidisciplinary approach to deliver exceptional care.
Facilities include:
- A hybrid operating theatre equipped for both open and endovascular procedures.
- State-of-the-art vascular diagnostics for accurate and efficient evaluation.
- Dedicated outpatient clinics with treatment rooms for specialised wound care.
Dr Choke is recognised internationally for his contributions to vascular surgery and research, particularly in developing innovative techniques and devices to manage complex vascular conditions. Patients benefit from his global expertise, combined with a compassionate approach to care.
Take the First Step Towards Better Vascular Health
Peripheral arterial disease is manageable, especially when detected early. If you or a loved one experiences symptoms of PAD, seeking expert care can make all the difference.
Assoc Prof Edward Choke and the team at Northern Heart Hospital are here to guide you through diagnosis, treatment, and recovery. Contact us today to schedule a consultation and take a proactive step towards better vascular health.