Peripheral Arterial Disease (PAD)- Claudication, Rest pain & Critical ischemia

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Peripheral Arterial Disease (PAD)- Claudication, Rest pain & Critical ischemia.

Treatments for Peripheral Arterial Disease (PAD)

Investigations Commonly done for Peripheral Arterial Disease (PAD)

History & Examination

• Full history including family history of cardiovascular disease
• Examination of all the peripheral pulses including palpation of the Aorta
• Auscultation for bruits over the carotids, renal and femoral.
• Blood pressure estimation
• Resting comparison of pressure in foot arteries to pressure in upper limb arteries, called the Ankle Brachial Pressure Index or ABPI.

The normal ABPI is usually 1.

Blood tests

• Full blood count
• Urea & Creatinine estimation
• Clotting screen
• Blood glucose estimation
• Lipid profile, including cholesterol estimation
• Sometimes a thrombophilia screen is done

Laboratory Investigations

• Exercise pressure measurements including exercise ABPI (Walk test)

• Duplex ultrasound scanning

This is a non-invasive scan, which helps to identify the site and severity of the arterial narrowing.

• Arteriogram

This can be done either by injecting dye into the arteries called intra-arterial DSA or by an MRI scan called MR angiogram or by using a CT scan called a CT angiogram.

All of these methods give a 'road map' of the arteries and helps identify the sites of arterial narrowing.

(examples of intra-arterial DSA)