Mr Sabu Jacob, MBBS, FRCS (Gen)

General and Vascular Surgeon

Peripheral arterial disease

Peripheral arterial disease - or PAD – is a serious condition which increases your risk of heart attack and stroke, as well as other serious medical complications. 

PAD develops when some of your arteries (the big blood vessels which carry oxygen around your body) get clogged or furred up. This furring up of the arteries (the medical term for which is atherosclerosis) occurs because fatty deposits, or plaque, narrows and eventually blocks them in the same way that lime scale affects water pipes in the home. And just like water pipes, once the furring up of the blood vessels has occurred, it is difficult for fluid (blood) to get to where it is needed. Sometimes, the plaque ‘cracks’ open and a blood clot gets laid down on top of it, blocking the blood vessel completely.

The medical term for such a blockage caused by plaque is atherothrombosis. It can occur in many places in the body, including the arteries of your heart, brain, arms or legs – often in more than one area at a time.

What causes PAD?

  • Smoking
  • A high fat diet/high cholesterol
  • Being overweight
  • High blood pressure
  • Lack of exercise
  • Diabetes
  • Family history of heart disease/PAD or stroke

What are the symptoms?

  • Pain in the leg – usually in the calves, although may be present in the thighs and buttocks. The pain can sometimes wake you from sleep
  • ‘Rest pain’ – pain which comes on when your legs are rested. Particularly noticeable in toes. The pain is relieved when hanging legs down over the bed
  • One leg or foot colder than the other
  • The skin on one or both feet may be pale or blue-ish, especially when resting
  • Hair loss and slow-growing nails on leg/s
  • Cuts slow to heal on leg or foot
  • Ulcers on ankle or foot, which are slow to heal

If you have any of the above symptoms, you should make an appointment to see your GP as soon as possible. Your GP will examine you and may also take the blood pressure in your arms and/or ankles, as well as some blood tests. Your GP can then refer you to a consultant such as Mr Jacob for further tests and a closer look at your arteries.

Mr Jacob is able to advise, monitor and treat patients with PAD either with or without surgery. If surgery is not necessary, Mr Jacob will be able to help tackle your PAD with a combination of advice about life style changes (like stopping smoking and exercise) and prescribing drugs to control both cholesterol and blood pressure.

Surgery for PAD
If you do need surgery, there are 2 main options.

Angioplasty: this involves stretching a narrowed or blocked section of the artery with a balloon. It’s used for short sections of narrowing or blockage.

Bypass grafting surgery: involves replacing a section of blocked artery, usually with a synthetic tube. It’s usually reserved for long blockages causing severe symptoms. Bypass grafting is a more major operation than angioplasty.

How can Mr Jacob help?
If you have already been diagnosed with PAD, or are worried by any of the symptoms mentioned on this page, ask your GP to refer you to Mr Jacob at Spire Roding Hospital. He offers complete management of the condition - from initial diagnosis to the prescribing of drugs to prevent your symptoms from getting worse, right through to the performing of surgery for more serious cases. Mr Jacob can also advise you how to make lifestyle changes which will help reduce your chances of getting major complications from PAD.

Mr Sabu Jacob, Consultant Vascular Surgeon

Mr Jacob's clinic times at Spire Roding Hospital

  • Mondays: 6.30pm - 8.30pm
  • Thursdays: 2.00pm - 5.30pm
  • Saturdays: 9.00am - 11.00am
020 8709 7878