Lower leg arterial disease
As the population ages the amount of lower leg arterial disease increases. This is caused by “hardening of the arteries” in which plaque builds up in the walls of the vessels. Once this plaque starts blocking the blood flow it starts to affect the leg. Smoking and diabetes greatly increases the risk of getting arterial disease.
Disease without symptoms
With age, most people will develop “hardening of the arteries”. Many people can have blocked arteries in the leg without experiencing problems. Mr Brooks spends time with patients and their families to help alter their lifestyle, such as encouraging physical activity, weight loss, better diabetic control and ceasing smoking. Surgical interventions are rarely needed. Mr Brooks may also prescribe medications to reduce the risks of stroke, heart attack and further plaque formation.
Trouble Walking (claudication)
When the blockages get more profound, the leg can become painful when walking. This usually suggests the blood flow is satisfactory when resting but not when walking. Mr Brooks spends time with patients to navigate the multitude of possible therapies, ranging from careful watching to keyhole interventions such as balloon angioplasty or stent, and open bypass surgery.
Pain in the foot (rest pain) or Gangrene
When the blockages get so advanced that there is insufficient blood flow when resting, most patients will experience pain in their foot. This can progress to gangrene. This represents a major threat to the leg and timely invention is usually required. Mr Brooks has vast experience in keyhole balloon angioplasty and stents, as well as open surgical bypass. He takes time to discuss all the options with the patient and their families.
Some diabetic patients get ulcers despite not having blockages in the large blood vessels; these are often caused by the lack of protective pain sensation. When a patient has been diabetic for some time they often lack any feeling in the feet. This can cause major problems with ulcer formation and infection. At times, the patient may be unaware of any problem due to the lack of feeling and pain. Mr Brooks believes in working closely with the high risk foot clinic, close control of sugars, drainage of any infection, specialised foot wear and extensive patient education with close coordination with the GP.
Sudden leg pain (acutely ischaemic leg)
Sudden onset of leg pain requires immediate medical attention. Patients should present to the local Emergency Department.