Claudication/leg pain
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Claudication/leg pain

Calf pain on walking may be associated with disease of the artery supplying blood to your left.

Peripheral vascular disease
What is it
This refers to symptoms causes by a narrowing or total blockage of the artery which supply blood to your legs. Typical symptoms are:
•calf pain on walking (claudication)
•buttock or thigh pain on walking
•pain in the foot at rest
•ulcer or gangrene of the ankle or foot

image51image52How is it diagnosed
Diagnosis is based on a history and then examination of the legs. Following this patients would undergo scanning with either a hand held Doppler or a duplex scan (ultrasound of the arteries) to look for evidence of narrowing of the artery. This will then allow the consultant to make a decision on the treatment. Further investigations include an angiogram (to get a picture of your arteries) using a CT or an MRI scan.

Why should I have it treated
Patients will want treatment because they have symptoms associated with the narrowing of the arteries as described above. If there is severe pain or gangrene then treatment is needed to reduce the risk of amputation.

When should it be treated
Your consultant will decide on the need for treatment after assessing your symptoms and then examining you. Treatment will also then be based on any further investigation you undergo.

How can it be treated
The initial treatment will consist of reducing your risk factors such as asking you to stop smoking, increasing your exercise, controlling your blood pressure and starting you on tablets to thin your blood (such as aspirin) and a tablet for lowering your cholesterol (a statin). If these measure are not effective or if there is a risk of amputation then the treatment can be either conventional surgery or endovascular (using minimally invasive techniques).

Minimal invasive treatment: This include doing an angiogram followed by an angioplasty (ballooning of the artery) or putting in a stent (a metal cage to keep the narrowed artery open). This is usually undertaken under local anaesthetics. These have some differences in risk compared to open surgery and again this will be discussed with you. This technique generally allows you to go back to normal activities more quickly than open surgery.

Open surgery: This involves a bypass either using your vein as the bypass material or a artificial graft. Using the vein is a more durable solution but if this is not possible then an artificial material is used. There are some major risks of the operation which will be discussed with you by your consultant.