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Despite a fall in the number of deaths due to circulatory diseases over the last decade, they remain the commonest cause of death in England and Wales. 1 There is increasing recognition that peripheral arterial disease (PAD) is an independent risk factor for both myocardial infarction and stroke. Further, treatment of PAD reduces this risk. This review of the literature highlights the recent developments in the management of lower limb PAD.

PAD is a term used to describe the impairment of blood flow to the extremities usually as a result of atherosclerotic occlusive disease. 2 Generally speaking, the presence of symptoms in PAD depends on the metabolic demands of the ischaemic tissue during exercise, the degree of collateral circulation and the size and location of the affected artery. 3