Peripheral Artery Disease

Peripheral Artery Disease, or PAD, is a common circulation problem in which the arteries that carry blood to the legs or arms become narrowed or clogged. This interferes with the normal flow of blood, sometimes causing pain, but often causing no symptoms at all. The most common cause of PAD is atherosclerosis, often called “hardening of the arteries”. Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, forming a substance called “plaque” that clogs the blood vessels.


In some cases, PAD may be caused by blood clots that lodge in the arteries and restrict blood flow. Left untreated, this insufficient blood flow will lead to limb amputation in some patients. In atherosclerosis, the blood flow channel narrows from the buildup of plaque, preventing blood from passing through as needed, restricting oxygen and other nutrients from getting to normal tissue. The arteries also become rigid and less elastic, and are less able to react to tissue demands for changes in blood flow.


PVD affects about 1 in 20 people over the age of 50, or about 8 million people in the United States. If you are over the age of 50, or have hypertension, diabetes, or high cholesterol, you run a greater risk of developing PVD. Smokers and those who are overweight or don't exercise regularly are also at risk. Simply ignoring your symptoms is not an option. Many people simply live with their pain, assuming it is a normal part of aging, rather than reporting it to their doctor. If you are expereincing one or more of these symptoms, contact a physican today.


SYMPTOMS

The most common symptom of PAD is called claudication, which is leg pain that occurs when walking or exercising and disappears when the person stops the activity. Other symptoms of PAD include:

  • Cramping, leg or hip pain which occurs when you walk, but goes away when you rest
  • Numbness, tingling or weakness in the legs
  • Burning or aching pain in your feet or toes when resting
  • A sore on a leg or foot that won’t heal
  • Cold legs or feet
  • Loss of hair on your legs

The most common test for PVD is the ankle-brachial index (ABI) and arterial Doppler, a painless exam which compares the blood flow between your feet and arms. Based on the results of your ABI, as well as your symptoms and risk factors for PVD, a doctor can decide if further tests are needed. If the ABI test indicates that you may have PVD, other imaging modalities — such as an angiogram — are typically ordered to confirm the diagnosis. On occasion, MRI scanning or CT scanning might be ordered.


TREATMENT OPTIONS

The treatment your doctor recommends will depend on your overall health as well as the severity of the disease. Here are a few options:


Lifestyle Changes

In most cases, lifestyle changes can be enough to slow the progression of, or reverse, the disease. Your doctor may suggest that you quit smoking, begin an exercise regimen, and change your diet to one that is lower in fat and cholesterol. Other factors include:

  • Control diabetes
  • Control blood pressure
  • Eat a low-saturated-fat, low-cholesterol diet

Medication

Some people will need to take a cholesterol-lowering medication, or medication that controls high blood pressure. These may be prescribed in addition to lifestyle changes.


Procedures to Open Blocked Blood Vessels

There are a number of procedures that doctors use to open blood vessels at the site of blockages caused by PVD. In many cases, these procedures can be performed without surgery using modern, interventional radiology techniques.


Surgical Procedures

Most of the time, lifestyle changes, medication and/or an interventional procedure can alleviate PVD. Sometimes, however, surgical intervention is needed. Surgery for PVD is performed by cardiothoracic or cardiovascular surgeons. Your physician can determine what the best treatment option is.


NEED MORE INFORMATION ON PERIPHERAL ARTERY DISEASE?

American Heart Association

Society of Interventional Radiology