Peripheral artery disease

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 4, 2016
StartDiseasesPeripheral artery disease

Peripheral artery disease (PAD) is a common problem that affects the circulatory system. Those who have this disease have problems with blood flow, which causes pain in the lower extremities. Peripheral artery disease (PAD) is a term that describes the narrowing of peripheral arteries in the legs and other parts of the body.

Contents

Definition & Facts

Peripheral artery disease occurs as a result of atherosclerosis. Those who have this disease often experience pain when walking or climbing stairs. Patients can usually relieve their pain by resting, but the pain may return once they start moving again.

Doctors often fail to diagnose PAD properly. Those who have PAD are also at a higher risk of having a stroke, heart attack, or developing coronary artery disease.

Symptoms & Complaints

Pain is the most common symptom of peripheral artery disease. While this pain can occur anywhere in the body, most patients experience pain in their lower extremities. For example, they often experience cramps in their thighs and calves when walking or working out.

This pain usually goes away when they sit down because resting muscles do not need as much blood flow. The pain is the body’s way of warning a person that he or she is not receiving enough blood flow to keep moving at a quick pace. Additional symptoms are ulcers and skin color changes.

A person can experience mild discomfort or debilitating pain. Those who have debilitating pain often struggle to walk or perform other routine daily tasks. If the disease progresses without proper treatment, patients will start experiencing pain when they are resting. Sometimes, this pain is intense enough to keep people from getting a full night of sleep.

People may start noticing that wounds on their feet are healing slowly and that their nails look unhealthy. Their legs may start feeling colder than the rest of their body. Peripheral artery disease can cause gangrene if there is no circulation of blood to the feet or extremities.

Causes

Most cases of peripheral artery disease occur when plaque forms on the artery walls. These fatty deposits prevent blood from flowing smoothly. When these deposits become too large, blood clots often form.

The disease can also occur if the body sustains damage to the inner layers of the arteries. For example, smoking and diabetes mellitus are two factors that can cause damage within the arteries. When damage occurs, the body automatically responds by trying to heal itself. Unfortunately, this healing process can cause plaque to form in the arteries.

A person can also develop peripheral artery disease from inflammation, which restricts blood flow. Although it is less common, limb injuries can also cause PAD to occur.

When a blocked blood vessel prevents total loss of circulation in the lower extremities, gangrene can develop. A blocked artery can also cause a stroke. Those who were born with unusual anatomy of their ligaments or muscles are also at a higher risk of developing PAD. Radiation exposure is another factor that can lead to painful artery problems.

Diagnosis & Tests

The diagnostic process will involve performing a physical examination. During the physical exam, doctors use a stethoscope to listen for a weak pulse or whooshing sounds near the arteries. They also spend this exam checking for evidence of poor wound healing and decreased blood flow in the lower limbs.

Doctors can also use the ankle-brachial index to check for PAD. The doctor takes a blood pressure reading in the ankle and another one in the arm to compare numbers. An ultrasound is another useful tool which doctors can use to examine blood flow and find narrowed arteries.

During an angiography, a doctor injects dye into the blood vessels. This method allows the doctor to use imaging techniques to watch blood flow through the arteries. Another diagnostic tool is a blood test. The doctor will take a sample of blood to measure a person’s cholesterol and triglyceride levels. 

Treatment & Therapy

A proper treatment plan can help patients manage their symptoms so that they can perform routine activities without pain. In addition, another treatment goal is to stop the disease from progressing before it leads to a heart attack or stroke.

One way to treat peripheral artery disease is by taking medication. Certain medications can lower cholesterol levels such as statins, while others can lower hypertension (antihypertensive drugs).

Those who have diabetes may need medication to control their blood sugar. Doctors can also prescribe medication that helps reduce blood clots such as anticoagulants. Improved blood flow to the limbs helps eliminate the pain associated with PAD.

In some cases, medication is not enough to treat the disease. For example, a patient may need to undergo bypass surgery. With this type of surgery, doctors can manipulate the body in a way that allows blood to pass around the blocked or narrowed artery.

Another treatment option that doctors often use is angioplasty. During this procedure, the doctor threads a catheter through the blood vessel to reach the affected artery. Once there, the doctor uses a small balloon on the catheter to stretch the artery open and flatten the blockage. Sometimes, the doctor may even insert a stent into the artery to ensure that it remains open. 

Prevention & Prophylaxis

There are certain actions that people can take to reduce their risks of developing peripheral artery disease. One of the most important actions is to perform regular exercise. Those who are in good physical shape are less likely to develop PAD.

Smokers should quit smoking. Quitting is one of the most important ways to prevent PAD symptoms. In addition, people should also follow a healthy diet. This includes eating more fruits and vegetables and less junk food. These lifestyle changes can help prevent diabetes, heart disease, and high blood pressure.