What is Peripheral Artery Disease?
Peripheral Artery Disease (PAD) is a common disease that occurs when the blood vessels that supply blood to the limbs and other organs of our body are partially or completely blocked due to plaque build-up, a condition called atherosclerosis. Plaque forms out of the substances present in the blood such as fat, cholesterol, calcium and fibrous tissue. These plaque deposits gradually harden and narrow down the arteries. This limits the oxygen-rich blood supply to the various parts of your body. The most commonly affected blood vessels by PAD are the arteries of the legs.
Symptoms Of Peripheral Artery Disease
The main symptoms of peripheral arterial disease can be divided into two categories:
Claudication:
The common symptoms of claudication include:
- Difficulty in walking
- Pain and muscle cramps in the legs while walking or climbing stairs (intermittent claudication)
Critical Limb Ischemia:
- Pain in the legs even at rest.
- Sores on toes and feet, which do not heal or heal slowly.
Other symptoms of peripheral arterial disease include:
- Numbness, weakness or heaviness of the muscles
- Cold sensation of the skin in the legs or feet
- Discoloration of the skin, predominantly in the arms or legs
- Burning or aching sensation in the feet and toes
Diagnosis of Peripheral Artery Disease
Peripheral artery disease screening is very useful in certain groups such as individuals above 55 years of age as they are at high risk of developing atherosclerosis and vascular disease. Other conventional risk factors for developing the vascular disease include:
- Diabetes Mellitus
- High blood pressure
- Obesity
- Lack of exercise
- Smoking
- High blood cholesterol
- Family history of atherosclerosis and circulatory problems
Screening helps in detecting early signs of PAD that can be potentially treated before further deterioration of the condition. Peripheral artery disease screening involves painless and non-invasive tests, which include:
- A medical and family history
- Medication review
- Leg pain assessment
- Blood pressure reading
- Body fat analysis
- Body mass index
- Cholesterol panel
- Blood glucose estimation
- Lipid profile
- Ankle-brachial index -Ankle-brachial index (ABI) compares the blood pressure of your ankle to blood pressure in the arm.
If there is concern for PAD, more advanced tests can be performed:
- Segmental Pressure and Pulse Volume Recordings – Blood pressure cuffs are placed at multiple spots on your legs and possibly the toes to measure pressure and volume to find arterial blockages. This test may be performed after exercise for more sensitive results.
- Doppler ultrasound - Ultrasound is used to directly visualize the blood flow in your arteries. This test may be performed after exercise for more sensitive results.
- Computed Tomography Angiography (CTA) – In CTA, dye is injected into your bloodstream through a an IV (intravenous) access. Blood vessels and the flow of dye inside are directly visualized using spinning X-rays to help detect narrowings and blockages.
- Magnetic Resonance Angiogrophy (MRA) – In MRA, magnetic and radio waves are used to produce images of blood vessels similar to CTA.
- Catheter Angiography - In catheter angiography, the arteries are directly accessed with small tubes called catheters. The catheters are used to inject dye or carbon dioxide to take special x-ray pictures of what the vessels look like. This more invasive test is usually performed prior to treatments like atherectomy, angioplasty, and stenting.
Therapies for Peripheral Artery Disease
The goals of PAD treatment are to reduce symptoms, improve quality of life and prevent complications. In most cases, the early stages of peripheral artery disease can be effectively treated by lifestyle modifications, medication, or a combination of both. Smoking cessation, diet and nutritional modification and regular exercise also help in the management of PAD. In more severe cases, invasive procedures such as angioplasty, atherectomy, and stenting may be needed. In certain cases, bypass surgery may be needed.
Medical therapy
This includes medication to lower high cholesterol and blood pressure levels. Also, medicines that prevent the formation of blood clots and relieve leg pain may be given.
Lifestyle changes
Stop smoking as smoking increases your risk of PAD by four times. Exercise regularly and be physically active. Get your blood pressure, cholesterol, and blood sugar level monitored regularly to avoid the risk of stroke and heart disease. Eat a well-balanced diet with a lower amount of fats and salt.
Catheter-based therapy
Catheter-based therapy involves the following procedures:
- Angioplasty and Stenting: Angioplasty is a procedure done to restore blood flow through a blocked artery. It involves the passage of a catheter with a deflated balloon at its tip into a blocked artery. The balloon is then inflated to displace the plaque outwards. This restores the blood flow by widening the artery. In addition, a stent may be placed in the artery to keep it open after angioplasty is done.
- Atherectomy: This is a procedure in which a catheter with a small cutting device is passed into the blocked artery. This device breaks up the plaque into bits which are removed through the catheter or by the bloodstream.
Articles
Joliet Woman Feels Like She Has a New Set of Legs Following PAD Treatment at Silver Cross
Joliet resident Beverly Dixon, 63, says she feels like a woman half her age following treatment for peripheral artery disease at Silver Cross Hospital in New Lenox.
Published on Sept 10, 2019
