PERIPHERAL ARTERIAL DISEASE
What is Peripheral Arterial Disease
Peripheral arterial disease (It is also known as peripheral arterial disease, peripheral vascular disease or PAD) is a circulatory issue where blood flow is reduced to your limbs. This is often a result of plaque buildup or atherosclerosis in your arteries. While this disease often occurs in your legs, it may also be reducing blood flow to your heart or brain.
When you develop peripheral arterial disease (PAD), your extremities don’t receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (claudication).
Peripheral artery disease is likely to be a sign of fatty deposits in your arteries. This is referred to as atherosclerosis. You often can successfully treat peripheral artery disease by quitting tobacco, exercising and eating a healthy diet.
Approximately half of individuals with peripheral vascular disease experience mild to no symptoms. The most common symptom is leg pain while walking (claudication). The severity of claudication can vary from mild discomfort to debilitating pain.
Signs and symptoms of peripheral artery disease are:
- Fatigue or cramping of your muscles in the calf, thigh, hip, or buttock may signal you have PAD. Typically the discomfort is felt after walking a certain distance.
- Leg numbness or weakness
- Coldness in your lower leg or foot, especially when compared with the other side
- pain in your toes or feet while resting, may demonstrate an advancing case of PAD.
- An open wound or ulcer on your toes or feet. This often at a pressure point on the foot. An ulcer can progress to gangrene. These symptoms require immediate medical attention.
- Hair loss or slower hair growth on your feet and legs
- Shiny skin on your legs
- No pulse or a weak pulse in your legs or feet
- Erectile dysfunction in men
Causes of peripheral vascular disease
Peripheral vascular disease is often caused by fatty deposits or plaque that builds up on the artery walls. This is also known as atherosclerosis and it can reduce your blood flow.
Often, atherosclerosis is discussed with heart disease and can effect any artery. However, when it occurs in arteries supplying your limbs it is referred to as peripheral arterial disease.
The causes of PAD include smoking, high cholesterol, high triglycerides, high blood pressure, diabetes, kidney failure and obesity. It is possible genetic factors could play a role. Less commonly, blood vessel inflammation, injury to your limbs. Also, unusual anatomy of your ligaments or muscles, or radiation exposure can cause PAD.
Diagnosing Peripheral Arterial Disease
Some of the tests that are used to diagnose peripheral artery disease are:
- Physical exam. Peripheral Vascular Disease can be found during a physical examination. This can occur through symptoms such as a weak or absent pulse below a narrowed area of your artery. As well as, whooshing sounds over your arteries that can be heard with a stethoscope. Additionally, evidence of poor wound healing in the area where your blood flow is restricted, and decreased blood pressure in your affected limb.
- Ankle-brachial index (ABI). This is a common test used to diagnose PAD. It compares the blood pressure in your ankle with the blood pressure in your arm. To get a blood pressure reading, a regular blood pressure cuff and a special ultrasound device to evaluate blood pressure and flow.Another method would be to walk on a treadmill and have readings taken before and immediately after exercising. This can capture the severity of the narrowed arteries during walking.
- Ultrasound. Special ultrasound imaging techniques, such as Doppler ultrasound, can help your doctor evaluate blood flow through your blood vessels and identify blocked or narrowed arteries.
- Angiography. Using a dye (contrast material) injected into your blood vessels. This test allows your us to view blood flow through your arteries as it happens. Your doctor is able to trace the flow of the contrast material using imaging techniques, such as X-ray imaging or procedures called magnetic resonance angiography (MRA) or computerized tomography angiography (CTA).
- Blood tests. A sample of your blood can be used to measure your cholesterol and triglycerides and to check for diabetes.
PAD is a serious condition. Clogged arteries caused by decreased blood flow can cause painful cramping while walking or exercising. Numbness, weakness or tingling in the legs and feet and burning pain in feet and toes are other side effects. In serious cases, Peripheral artery disease of known for causing critical limb ischemia. This is a condition that begins as open sores that do not heal. These sores will progress to tissue depth causing gangrene. Sometimes requiring amputation of the affected limb.
Additionally, a major complication caused by peripheral vascular disease is the risk of a stroke or heart attack. The atherosclerosis that causes the signs and symptoms of peripheral artery disease isn’t limited to your legs. Fat deposits also build up in arteries supplying blood to your heart and brain.
The best way to prevent peripheral arterial disease is to maintain a healthy lifestyle. That means:
- Quit smoking if you’re a smoker.
- If you have diabetes, keep your blood sugar in good control.
- Exercise regularly. Aim for 30 to 45 minutes several times a week after you’ve gotten your doctor’s OK.
- Lower your cholesterol and blood pressure levels, if applicable.
- Eat foods that are low in saturated fat.
- Maintain a healthy weight.
In order to salvage the limbs, PAD is medically treated with prescribed medications. These medications treat high cholesterol, control blood pressure. As well as, decrease pain while walking in order to increase exercise. They also aim to prevent the buildup of plaque or formation of blood clots.
Peripheral artery disease is also treated using minimally invasive interventional radiology procedures. Angioplasty is opening a blocked artery with a medical balloon, enabling better blood flow. In some cases, the affected arteries need to remain open using a stent, which is a small metal cylinder. This treatment is stenting.
A stent-graft is another procedure. This is when a stent covered with a synthetic fabric is placed in the blood vessels to bypass affected arteries. A third interventional radiology procedure for peripheral artery disease called atherectomy. This procedure uses small catheter at the site of the blockage in order to shave the plaque away from the inside of the artery and remove it from the patient’s body
In some cases, PAD may be serious enough that a medical team has no choice but to perform surgery. This may be the only way to remove blockages or create bypasses around the clogged areas.