Poor Leg Circulation: What an Assessment Involves

If you've been told you may have poor circulation in the legs, the first question is not "do I need a procedure?" The better question is: how bad is the blood flow, and where is the blockage? Peripheral arterial disease, or PAD, means that the arteries supplying blood to the legs have become narrowed or blocked. This can cause pain in the calf, thigh or buttock when walking, which improves after resting. Some patients notice cold feet, numbness, poor pulses, slow-healing wounds, ulcers or even black toes.

When you see a vascular specialist, the assessment starts with the story. How far can you walk? Where is the pain? Does it settle when you stop? Do you have diabetes, kidney disease, a smoking history, heart disease or previous arterial treatment? Then we examine the legs and the feet. We look at the pulses, skin colour, temperature, wounds, ulcers, signs of infection, and whether the foot is at risk. The next step is usually testing the blood flow.

The scan is important because the treatment depends on the pattern of disease. Some patients need exercise therapy, medication and risk-factor control. Some need angioplasty or stenting. Some need bypass surgery. Some need urgent treatment because a wound or toe is at risk. So the aim is not just to open an artery. The aim is to match the treatment to the symptoms, the scan findings, the wound risk and the patient's overall health.