Peripheral arterial occlusive disease (PAD)

PAD is one of the most common vascular diseases. In 95% of cases, it is caused by hardening of the arteries (arteriosclerosis).

Intermittent limping (claudication)

The diminishing ability to walk without pain is usually the first symptom of this chronic, slowly progressive and multifactorial vascular disease.

In later stages, pain and tissue death, usually in the feet, can occur even at rest. This is known as chronic limb-threatening ischaemia (CLTI). Acute limb ischaemia (ALI) is an acute occlusion of a blood vessel, resulting in an acute circulatory disorder of a limb.

Treatment

Depending on the stage of the disease, modern treatment of peripheral arterial disease is multimodal. It is always based on individualised drug therapy for risk factors such as high blood pressure, elevated blood lipid levels and diabetes, and therapy with a so-called antiplatelet drug, which prevents the formation of thrombi, i.e. blood clots in the blood vessels. The therapy also includes giving up nicotine and making lifestyle changes, especially in terms of diet. Intensive walking training is also very effective, depending on the stage of intermittent claudication.

You will be given information and instructions on walking training during your appointment at the University Hospital Outpatient Clinic.

We treat peripheral arterial disease individually for each patient, according to their stage and risk factors. The range of treatments includes, among other things:

• Less invasive, endovascular techniques, such as balloon dilatation (PTA)
• Stent implantation
• Interventional removal of calcium plaques (directional atherectomy)
• Local open surgical procedures such as open thrombectomy or the creation of vascular bypasses from the body's own vein or plastic (peripheral bypass surgery)
• Improving blood flow by neuromodulation (neurostimulator) or nerve block (CT-guided sympathicolysis)

Dead tissue usually needs to be removed. However, the aim is always to perform only minor amputations and to avoid major amputation, i.e. the loss of the foot or leg above the ankle joint.