Peripheral arterial disease (PAD) is a circulatory disorder in which peripheral arteries become narrow, blocked or go into spasm. It can be thrombotic, embolic or ischaemic in origin and causes pain or fatigue;at rest or after walking, commonly in the legs.
Medications:
Acute arterial occlusion:
- Inj. Troyhep 5000 IU (Heparin 1000 units/ml) 5000 I.U; I.V. immediately followed by 1000 units/hour continuous I.V. infusion.
- Tab. Dolo 650 (Paracetamol 650 mg) 1 tablet 3 times a day.
- Consider Inj. Streptase 75000 IU (Streptokinase 75000 IU/ml) 6000 units/hour through the catheter in the affected vessel.
- Consider reconstructive arterial surgery in cases with critical arterial ischaemia.
Chronic lower limb arterial ischaemia:
- Tab. Ecosprin 75 (Aspirin 75 mg) 1 tablet once a day with dinner.
- If intolerance to aspirin – tab. Clopikind 75 (Clopidogrel 75 mg) 1 tablet once a day.
- Treat raised cholesterol, raised sugars and hypertension.
General advice:
- Foot care by daily inspection
- Avoid infection over the affected site
- Watch for ulcers and treat aggressively
- Advice good footwear to reduce injuries
Investigations:
Arterial duplex ultrasound – to identify location and extent of blood clot and occlusion.
Referral:
Consider further referral to vascular surgeon in all cases.