Peripheral Artery Disease

Peripheral Arterial Disease (PAD) occurs when plaque builds up and clogs the arteries and prevents the extremities, primarily the legs but sometimes the arms, from receiving enough blood flow to keep up with demand. The plaque deposits can cause the arteries to stiffen and become narrow or blocked which would then limit blood flow. Peripheral arterial disease is also likely to be a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis).

Symptoms

Peripheral artery disease can often be asymptomatic. However, when symptoms do appear, the most common is pain or cramping in the hips, thighs or calves when walking.

• Other symptoms include:
  
• Leg fatigue or heaviness
• Pain in the feet while at rest
• Numbness or tingling in the legs or feet
• Burning or tingling in the feet
• Loss of hair on the feet or toes
• Coldness in the lower legs or feet
• Weak pulse in the legs or feet
• Sores or ulcers on the legs or feet

Risk Factors

Hardening of the arteries and plaque buildup is normal as you age. However, certain risk factors can lead to developing PAD sooner:

• Diabetes
• Smoking
• Hypertension
• High cholesterol
• Obesity
• Family history
• Age >50
  

Diagnosis

In order to diagnose PAD, certain tests or examinations may be conducted in order to measure blood flow through the arteries.

• Ankle-brachial index (ABI)–compares blood pressure measured in the ankle to blood pressure measured in the arm
• Ultrasound–used to evaluate blood flow and narrowing or blockages in the blood vessels
• Computerized tomography (CT) scan or magnetic resonance imaging (MRI)–creates an image that shows blockages in the arteries
• Angiography–can allow a doctor to see the exact location of a blockage with fluoroscopy and contrast dye
  

Treatment

• Treatment of PAD may involve medications or lifestyle modification, which can include smoking cessation, lowering blood pressure and cholesterol, blood sugar control in diabetics, or supervised exercise programs. Severe cases may involve further treatment to restore blood flow to the legs and feet.
• Endovascular repair–uses the insertion of a stent or balloon angioplasty to keep the artery open through a small puncture in the groin. It is a minimally invasive out patient procedure requiring no incision.
• Atherectomy–removes the plaque from within the artery using catheters
• Open surgical bypass–allows a blood vessel made of the patient’s vein or a synthetic fabric, to allow blood flow around the blocked or narrowed artery.