Peripheral Arterial Intervention
Peripheral arterial disease (PAD) results from the deposition of cholesterol and calcium in the arteries supplying blood to the legs and sometimes the hands. It is closely linked to heart disease and stroke and caused by similar lifestyle factors of smoking, diabetes and a sedentary lifestyle. Blockages of these arteries to the limbs leads to a progressive loss of blood flow with symptoms of calf pain, decreased walking distances and in severe cases amputation of the limb. The growing epidemic of diabetes in the world and in Singapore (where it is estimated to affect over 11% of people) means that PAD and amputations of toes and limbs from it are also rising.
We offer simple screening tests like ABI (ankle brachial index) to detect disease early, diagnostic ultrasound Duplex scans, as well as the full range of peripheral arterial angioplasty, stenting and limb bypass surgery to re-establish blood flow and prevent amputations. This is complemented by our expert cardiology physicians who manage the risk of heart disease and stroke associated with the condition.
Peripheral angioplasty is an endovascular (keyhole) procedure performed under a local anaesthetic in which a wire is passed across the blockage in the artery through a small plastic tube inserted in the groin. A balloon is then passed over this wire and opened at the site of the blockage to re-establish blood flow to the limb beyond the blockage.
Sometimes the blockages are extremely hard (due to calcium) to stay open with just a balloon angioplasty and a fine metal tube called a stent may need to be inserted across the blockage to keep the artery open.
In severe disease of the arteries, blockages may be too extensive in length or too many in number to be treated by a balloon angioplasty. In such cases, blood flow may have to be re-established by an operation called a bypass where the blockages are crossed using a tube from above the blockage to below it. The tube is usually the patient’s own leg vein, though sometimes a special artificial tube called a graft may be necessary if the patient’s own vein is not suitable.