Symptoms by Severity
| Stage | Symptoms |
|---|---|
| Asymptomatic | No symptoms, found incidentally or on screening |
| Intermittent claudication | Leg pain/cramping on walking, relieved by rest — classic symptom |
| Rest pain | Pain even at rest, especially at night — more severe disease |
| Critical limb ischaemia | Non-healing ulcers, gangrene — limb-threatening emergency |
The Ankle-Brachial Index (ABI) Test
| ABI Value | Interpretation |
|---|---|
| 1.0-1.4 | Normal |
| 0.9-1.0 | Borderline |
| 0.4-0.9 | Mild-moderate PAD |
| <0.4 | Severe PAD |
| >1.4 | May indicate calcified, non-compressible vessels (common in diabetes) — further testing needed |
Treatment Approach
- Smoking cessation — the single most important intervention
- Supervised exercise programme — improves walking distance significantly
- Statins and blood pressure control — reduce cardiovascular risk
- Antiplatelet therapy (aspirin or clopidogrel)
- Angioplasty/stenting or bypass surgery for severe or limiting symptoms
Critical Limb Ischaemia — EmergencySudden severe leg pain, pale/cold leg, or non-healing ulcers with reduced pulses require urgent vascular assessment, as this can progress to gangrene and limb loss without prompt treatment.
PAD Is a Marker of Whole-Body Vascular DiseaseHaving PAD significantly increases the risk of heart attack and stroke, as it reflects widespread atherosclerosis. Aggressive management of cardiovascular risk factors is essential, not just leg symptom control.
Is leg pain when walking always PAD?
No — spinal stenosis can cause similar walking-related leg pain (neurogenic claudication), but typically improves with leaning forward or sitting rather than just standing still, unlike vascular claudication.
Can PAD be reversed?
Established atherosclerotic narrowing doesn't reverse, but disease progression can be significantly slowed, and symptoms improved, with smoking cessation, exercise, and medical treatment.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.