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Peripheral Artery Disease

Peripheral arterial disease is a form of atherosclerosis. It is a progressive disease that involves the hardening and narrowing of the arteries due to a gradual buildup of fatty deposits. It is a serious condition that results from the narrowing of the arteries that supply blood and oxygen to the parts of body such as legs, arms or neck and heart.

The most common reason for this disease is the accumulation of excess cholesterol, calcium and other substances inside the walls of the arteries. It’s also called PAD, a disease of the blood vessels.

As the arteries block up and harden, they narrow down and this affects the flow of blood to other parts of the body. As the arteries narrow, the heart and other parts of body such as legs do not get the required amount of blood. This disease occurs mostly in the arteries outside of the heart that are called peripheral arteries.

PAD interferes with one's lifestyle by decreasing walking ability and affecting cardiovascular health due to lack of blood supply. If it’s left untreated, PAD increases the risk of heart attack, stroke, amputation of lower limbs and even death. A patient suffering from PAD has five times the risk of a heart attack or stroke over the next ten years as the patient who does not have peripheral arterial disease.

Symptoms of Peripheral Artery Disease

• Pain, ache, cramp and severe fatigue in one or both of the legs while walking
• Due to poor circulation, pain may also occur in toes and feet
• Gangrene and ulcers in the foot or limbs
• Decreased leg strength when trying to stand up
• A marked decrease in the temperature of the lower limbs of the body as compared to other limbs
• Foot or toe wounds that will heal very slowly

Peripheral Artery Disease diagnosis

PAD often goes undiagnosed. This can be dangerous because PAD can lead to painful symptoms, loss of a leg and increased risk of coronary artery disease and carotid atherosclerosis.

Your doctor may carry out a complete physical examination of the weak pulses in the legs. The ankle-brachial index (ABI) test is also usually done that compares the blood pressure in your feet to the blood pressure in your arms to determine the flow of blood.

Doppler and Ultrasound (Duplex) imaging is a non-invasive method that actually visualizes the artery with sound waves and measures the blood flow in an artery to detect the presence of a blockage.

Computed Tomographic Angiography (CT) is a non-invasive test that can show the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents.

Magnetic Resonance Angiography (MRA) is another non-invasive test that gives information similar to that of a CT without the use of X-rays.

Angiography is sometimes done in conjunction with treatment. During this test a contrast agent is injected into the artery and X-rays are taken to show arteries of the legs and any blockages that may be present.

Peripheral Artery Disease treatment

Exercise
Exercise is the most effective treatment for PAD. Your doctor may advice a supervised program of exercise for you. Simple walking regimens, leg exercise and treadmill exercise program 3-4 times a week can result in decrement of symptoms in as few as three months.

The program consists of exercise and rest in intervals in order to build up the amount of time you can walk before the pain sets in.

Diet
Many times, the causes of PDA may be elevated levels of cholesterol. A diet low in saturated fat and cholesterol can help lower blood cholesterol levels. With decrease in cholesterol PDA can be controlled.

Stop smoking
One of the big risk factors for PAD is smoking. It’s been reported that smokers suffer from PAD 10 years earlier than people who do not smoke.

Surgery
For patients where medicines and life style improvements do not work, surgery may be needed. Minimally invasive procedures consist of angioplasty or stent placement or clot-removal treatment. They are non surgical and are performed by making a small incision through which a catheter is inserted to reach the blocked artery. A tiny balloon is inflated inside the artery to open the clog. A stent is a tiny wire mesh cylinder may also be implanted at this time to help hold the artery open.
Sometimes a medicine can be given through the catheter or a special device can be inserted through it to remove a clot that is blocking the artery. If there is a long portion of artery in your leg that is completely blocked and you are experiencing severe symptoms, surgery may be needed. A vein from another part of the body can be used to bypass and reroute blood around the closed artery.

Medicines

• Your doctor may prescribe medicines to lower high blood pressure and cholesterol. These medicines will help in treatment of PAD.
• Other medications prescribed to improve the distance you can walk include cilostazol and pentoxifylline.
• You may be given anti-platelet medications like aspirin and clopidogrel to help to prevent blood clots.

PAD can be caused by a number of factors such as too much smoking, high cholesterol and lack of exercise. If these factors are improved upon, along with medicine, PAD can be easily treated. If not treated on time, it can prove to be dangerous and lead to a heart attack.