Peripheral Artery Disease - PAD Screening & Treatment in Singapore

What is Peripheral Artery Disease?

Peripheral artery disease (PAD) is a circulatory condition that most commonly affects the arteries in the legs. As these arteries become narrowed, usually due to fatty deposit build-up known as atherosclerosis, the muscles and tissues may not receive enough oxygen-rich blood, particularly during activity.

Early diagnosis is important. PAD is associated with a higher risk of heart attack and stroke, while severe loss of blood flow to the leg can progress to chronic limb-threatening ischaemia (CLTI) and increase the risk of amputation.

Symptoms of Peripheral Artery Disease

Common signs of PAD include:

Calf pain or cramping when walking (claudication)
Numbness or coldness in the lower leg or foot
Slow-healing foot wounds
Changes in skin colour or temperature of the leg or foot
Weak or absent pulses in the feet

In more advanced PAD, leg or foot pain may occur even at rest, particularly at night, and wounds may become increasingly difficult to heal. These can be signs of severely reduced blood flow and should be assessed promptly.

Some people with PAD have few or no noticeable symptoms, particularly in the earlier stages. PAD may instead be identified during an examination or vascular screening.

Why PAD Is Often Misdiagnosed or Overlooked

Many Singaporeans mistake the early warning signs of PAD for normal ageing, arthritis, or general fatigue, meaning the condition frequently goes undiagnosed by healthcare professionals until it reaches an advanced stage.

PAD can also be difficult to recognise because symptoms vary from person to person:

Some people experience only mild or occasional leg discomfort, while others may have no noticeable symptoms at all. Leg pain, weakness and numbness can also resemble symptoms of musculoskeletal or nerve conditions.

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Why Ignored PAD Is Dangerous

PAD is more than just a leg-related problem. It is a systemic vascular issue.

People living with PAD have a significantly higher risk of concurrent Coronary Artery Disease (CAD), heart attacks and strokes. Left untreated, chronic lack of blood supply can progress to Critical Limb Ischaemia (CLI), resulting in gangrene (dead tissue) and major leg amputation

Who Is at Risk?

While anyone can develop PAD, certain demographics and chronic health conditions prevalent in Singapore vastly accelerate arterial plaque buildup:

Diabetes Mellitus: Singapore has one of the highest rates of diabetes in the developed world, with approximately a 12% prevalence rate. Diabetes aggressively damages blood vessels, making diabetic patients highly susceptible to severe, multi-segment PAD.
Chronic Kidney Disease (CKD) / Dialysis: Patients with advanced CKD or end-stage kidney disease (ESKD) who are dependent on water or blood dialysis experience rapid calcification of their leg arteries, making the condition incredibly complex to treat.
Smoking: Tobacco use is the single most preventable cause of PAD. It accelerates plaque formation and constricts arteries.
Advanced Age, High Blood Pressure (Hypertension), and High Cholesterol (Hyperlipidemia).

How Is PAD Diagnosed?

If you display symptoms, a vascular specialist will perform non-invasive diagnostic tests to locate blockages:

Ankle-Brachial Index (ABI): A quick, painless test comparing the blood pressure in your ankle to the blood pressure in your arm.
Arterial Duplex Ultrasound: Uses sound waves to map out the exact location, length, and severity of the blockages in your leg arteries.
CT Angiography (CTA): A detailed imaging scan using contrast dye to create a 3D map of your blood vessels before scheduling surgical interventions.

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How Is Peripheral Artery Disease Treated?

Treatment for peripheral artery disease (PAD) depends on the severity of the condition and the extent of reduced blood flow.

Options range from managing risk factors and medication to minimally invasive procedures such as angioplasty and stenting, or surgery for more complex blockages.

Lower limb angioplasty and stenting

A minimally invasive technique using a needle to insert a wire into the groin artery and using balloons and/ or stents to open up the blocked leg and foot arteries.

Lower limb percutaneous atherectomy

A special form of minimally invasive surgery whereby a special device is temporarily inserted into the groin artery to remove the fatty/ cholesterol build up in the leg arteries and may be used in conjunction with ballooning and stenting.

Open peripheral arterial bypass/endarterectomy surgery

Sometimes the blocked leg arteries are too severe and extensive to be opened up with keyhole methods such as angioplasty and an open bypass using the patient’s vein or an artificial tube may be better to improve blood supply to the leg.

Hybrid procedure (combined open and minimally access) peripheral arterial surgery

For different parts of the blocked leg arteries:

Guard Your Circulation and Mobility

Peripheral artery disease can go undiagnosed until it has progressed considerably. If you experience persistent symptoms, particularly in the legs or feet, consider speaking to a vascular surgeon.

At The Vascular & Endovascular Clinic, our doctors and sonographers provide comprehensive vascular screening to detect PAD and assess for other vascular conditions. Prompt evaluation can allow for earlier treatment to improve circulation and reduce the risk of complications.

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FAQ - Patient Information

Why Does Peripheral Artery Disease Sometimes Affect One Leg More Than the Other?

PAD does not always affect both legs equally. Arteries in one leg may be more narrowed or blocked, causing more noticeable symptoms on that side.

Can You Have Peripheral Artery Disease Without Leg Pain?

Yes. Some people with PAD have mild, atypical or no noticeable symptoms, which is one reason the condition can remain undetected.

How Can I Tell if My Leg Pain Is From PAD or a Nerve Problem?

PAD typically causes aching, cramping or heaviness in the leg during walking that improves with rest.

Nerve-related pain is more likely to involve burning, tingling, numbness or shooting pain and may be affected by posture or movement.

As symptoms can overlap, a vascular assessment and tests such as an ankle-brachial index (ABI) or ultrasound can help determine whether poor circulation is the cause.

Can Peripheral Artery Disease Get Worse Without Symptoms?

Yes. PAD can progress even when symptoms are mild or absent. Regular follow-up and management of cardiovascular risk factors can help reduce the risk of complications.

Can Peripheral Artery Disease Be Reversed or Is It Permanent?

PAD cannot always be reversed, but it can be managed. Lifestyle changes, medication and appropriate treatment can help slow disease progression, improve symptoms and reduce cardiovascular risk.

When Does PAD Require Angioplasty or Stenting?

Angioplasty or stenting may be considered when PAD significantly limits daily activities despite other treatments, or when severely reduced blood flow threatens tissue or limb health.

People whose daily routine involves a lot of standing or sitting for long periods of time also have an increased risk of developing blood flow problems. If you’re looking for a vascular surgeon to help shed some light on your

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