Chronic limb ischaemia, also known as peripheral arterial disease, occurs when the arteries supplying blood to the legs become narrowed or blocked due to a build-up of fatty deposits (atherosclerosis). This reduces the supply of oxygen to the muscles and tissues.
Which symptoms should raise concern?
The most common signs include:
- Pain when walking that improves with rest (intermittent claudication)
- A feeling of coldness in the feet
- Wounds that do not heal
- In severe cases, a risk of gangrene
How can you improve circulation?
Treatment begins with lifestyle changes that can have a significant impact:
- Stopping smoking: this is the main risk factor
- Walking regularly: ideally as part of a supervised programme
- Eating a healthy diet: and keeping cholesterol, blood sugar and blood pressure under control
Treatment of ischaemia
Certain medications can help prevent complications and relieve symptoms:
- Antiplatelet agents (such as aspirin or clopidogrel) to prevent blood clots
- Statins to control cholesterol levels
- In some cases, medication to improve circulation and reduce pain when walking
When are medical procedures necessary?
If symptoms significantly limit daily life or there is a risk of complications, certain procedures may be recommended to restore blood flow:
- Angioplasty, with or without a stent: the artery is widened using a catheter and, if needed, a small tube is placed to keep it open.
Fig. 1. A: Balloon angioplasty of occluded distal runoff vessels (filled white arrows). B: Final result showing vessel patency (outlined white arrows).
- Bypass surgery: a new pathway is created using a vein or graft to bypass the blockage.
Fig. 2. Distal bypass at ankle level using autologous saphenous vein graft (white arrows).
Why is early detection important?
Current treatment combines healthy lifestyle habits, medication and, where necessary, medical procedures. Detecting the condition early is essential to prevent serious complications such as amputation.
Looking after your cardiovascular health, walking daily and stopping smoking not only improves symptoms but can also alter the course of the disease.
Information documented by:
Dr Vicenç Riambau. Head of the Angiology and Vascular Surgery Department at Hospital Clínic Barcelona.
