A private PAD clinic, by a specialist vascular team.

Prices vary by hospital, by the consultant, by lesion complexity and stent type, and by whether general or local anaesthesia is used. We come back with a firm quote within one working day.

1. 01

   Before

   You send us the referral or imaging

   A short, confidential form. Symptoms (walking distance, rest pain, ulcer), risk factors, ABPI or duplex if done, and any prior interventions.

2. 02

   Before

   We come back with a recommendation

   Within one working day: whether supervised exercise, endovascular angioplasty, bypass or best medical therapy fits. Indicative price. An honest read either way.

3. 03

   Before

   We arrange the clinic and imaging

   Usually within a week. ABPI, toe pressures, arterial duplex, CTA or MRA as needed. Antiplatelets and statin reviewed with the team before any intervention.

4. 04

   On the day

   Arrival at the vascular unit

   Consent and a chat with the consultant and anaesthetist. Local anaesthesia and sedation for most angioplasty, regional or general for bypass.

5. 05

   On the day

   The procedure

   Angioplasty and stenting via a common-femoral or radial puncture, 60 to 120 minutes. Fem-pop bypass is a two to three hour open operation.

6. 06

   On the day

   Recovery

   Day-case or overnight for endovascular. Three to seven days on the ward for bypass, with early mobilisation and wound review.

7. 07

   After

   Surveillance and risk factor clinic

   Duplex surveillance at 6 weeks, 6 months and yearly. Dual antiplatelet or aspirin plus low-dose rivaroxaban, high-intensity statin, smoking cessation and structured exercise.

• Intermittent claudication

  Cramping calf, thigh or buttock pain on walking, relieved within minutes of rest. Fontaine II, Rutherford 1 to 3.

• Rest pain and tissue loss

  Critical limb ischaemia: nocturnal foot pain relieved by dependency, non-healing ulcer or gangrene. Fontaine III to IV, Rutherford 4 to 6.

• Leriche syndrome

  Aortoiliac occlusion causing buttock claudication, absent femoral pulses and erectile dysfunction. Best treated by iliac stenting or aortobifemoral bypass.

• Diabetic foot with poor perfusion

  Neuroischaemic ulcer with reduced perfusion. Toe pressures and duplex needed because ABPI is often falsely raised by medial calcification.

• Restenosis after previous angioplasty

  Recurrent symptoms after prior PTA or stent. Duplex surveillance identifies in-stent restenosis suitable for drug-coated balloon or repeat stenting.

• Failing bypass graft

  Falling ABPI or new duplex stenosis in a vein graft. Early revision preserves the graft and avoids limb loss.

• Acute-on-chronic limb ischaemia

  Sudden worsening of a chronically ischaemic leg. Rutherford IIa to IIb needs urgent imaging and revascularisation within hours.

• Red flag: cold, pale, painful leg

  The six Ps (pain, pallor, pulselessness, paraesthesia, paralysis, poikilothermia) mean acute limb ischaemia. Go to A&E the same hour.

• Access-site haematoma and pseudoaneurysm

  Bruising at the groin puncture is common. Around 1 to 3% develop a pseudoaneurysm, usually managed with duplex-guided compression or thrombin injection.

• Contrast nephropathy

  Iodinated contrast can worsen renal function, especially with eGFR under 60. We hydrate before and after, minimise contrast volume, and pause metformin around the procedure.

• Distal embolisation

  Debris dislodged during angioplasty can travel downstream. Filters and aspiration catheters are used in high-risk cases; most events are managed on the table.

• Restenosis and stent thrombosis

  Restenosis occurs in 20 to 40% at one year for femoropopliteal work. Drug-coated balloons and duplex surveillance catch it early. Dual antiplatelet for 1 to 3 months post-stent.

• Bypass wound and graft infection

  Groin and leg wound infection occurs in 5 to 10% of open bypass. A prosthetic graft infection is rare but serious and needs specialist management.

• Cardiovascular event

  PAD is a marker of systemic atherosclerosis. Perioperative MI risk is 1 to 3%; long-term MACE risk is why statin, antiplatelet and BP control matter as much as the revascularisation itself.

• Amputation is a last resort

  Below-knee or above-knee amputation is reserved for unreconstructable disease, non-viable tissue or intractable pain. Every effort is made at limb salvage first.

• Aftercare and mobilisation

  Bed rest for 4 to 6 hours after femoral access, then walking. Bypass patients start walking on day one with physiotherapy and structured wound review.

• Red flags after discharge

  A cold, pale, painful leg, a new expanding groin lump, fever with a hot leg wound, or sudden loss of walking distance. Call the unit or go to A&E the same day.