The stages
- Claudication — cramping pain on walking, relieved by rest
- Rest pain — pain in the foot at night, often eased by hanging the foot out of bed
- Tissue loss — an ulcer or blackened area that will not heal
- Critical limb ischaemia — the limb is at risk without prompt treatment
What we can do
Early disease responds remarkably well to a supervised walking programme, stopping smoking and the right medication — often better than to any procedure.
Where the circulation must be restored, options include balloon angioplasty and stenting, subintimal angioplasty (a technique Prof Sultan helped pioneer), bypass surgery using your own vein, and hybrid procedures. For patients with no conventional option, deep venous arterialisation and home therapies to recruit the capillary bed can still save a leg.
