Peripheral arterial disease (PAD) affects million people across the world, so if you’ve heard of it, you’re not alone. But do you know what it really is?. Peripheral arterial disease is a common circulatory problem where narrowed arteries reduce blood flow to the limbs, typically the legs. This blog post by The Vascular and Interventional Centre will cover the causes, symptoms, diagnosis, and management of PAD, with the goal of providing you with a comprehensive understanding of this condition.
What is Peripheral Arterial Disease?
Peripheral arterial disease (PAD), also known as peripheral vascular disease, occurs when arteries in the legs and feet become clogged with fatty plaques, a process called atherosclerosis. This reduces blood flow, potentially leading to ischemia, where oxygen demand exceeds supply. In simpler terms, your legs aren’t getting enough blood!
Risk Factors
The risk factors for PAD mirror those of atherosclerosis:
- Cigarette smoking
- High LDL cholesterol
- Low HDL cholesterol
- Family history of atherosclerosis
- Elevated homocysteine levels
- Increasing age
- Male sex
- Obesity
- Diabetes
- Sedentary lifestyle
Symptoms of PAD
Approximately % of individuals with peripheral arterial disease experience no symptoms. However, when symptoms do appear, the most common is intermittent claudication.
Intermittent Claudication
Intermittent claudication manifests as pain, aching, cramping, or fatigue in the legs during walking, relieved by rest. It typically affects the calves but can also occur in the feet, thighs, hips, buttocks, or even arms. This discomfort arises from exercise-induced reversible ischemia, akin to angina pectoris.
Other Symptoms
Other signs and symptoms of PVD may include:
- Changes in skin temperature
- Thin, brittle, shiny skin on the legs and feet
- Weak pulses in the legs and feet
- Hair loss on the legs
- Numbness or coldness in the feet
- Gangrene (in severe cases)
- Impotence
Diagnosing PAD
PAD is often underrecognized, as many patients have atypical symptoms or are not active enough to experience symptoms. A healthcare professional will review your medical history and symptoms to diagnose peripheral arterial disease.
Diagnostic Tests
Several tests can help diagnose PAD:
- Ankle-Brachial Index (ABI): This common test compares blood pressure in the ankle to blood pressure in the arm. An ABI of ≤ . indicates PAD.
- Doppler Ultrasound: This ultrasound is used to spot blocked or narrowed arteries.
- Blood Tests: Blood tests can identify risk factors such as high cholesterol and high blood sugar.
- Angiography: Angiography uses imaging tests and dye to visualize blockages in the arteries.
- Magnetic Resonance Angiography (MRA)
Managing PAD
The goals of PAD treatment are to manage symptoms and improve artery health, reducing the risk of heart attack, stroke, and other complications.
Lifestyle Changes
Lifestyle modifications can significantly improve symptoms, particularly in early-stage PAD:
- Quitting Smoking: This is crucial, as smoking is a major risk factor.
- Regular Exercise: Exercise can improve circulation and reduce symptoms.
- Weight Loss: Maintaining a healthy weight can alleviate pressure on the arteries.
Medical Treatments
Your doctor may prescribe medications to manage PAD:
- Antiplatelet Drugs: These medications help prevent blood clots.
- Statins: Statins lower cholesterol levels.
- Cilostazol: Cilostazol can help improve blood flow and reduce claudication symptoms.
Procedures and Surgery
In severe cases, procedures or surgery may be necessary:
- Angioplasty: This procedure widens blocked arteries using a balloon catheter.
- Stent Placement: A stent can be placed in the artery to keep it open.
- Bypass Grafting: A bypass graft creates a new route for blood flow around the blocked artery.
The Vascular and Interventional Centre hopes this information helps you better understand PAD. If you experience any symptoms or have concerns, consult a healthcare professional for proper diagnosis and treatment.