Peripheral Artery Disease

\WHAT IS IT?

Peripheral artery disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop PAD, your extremities — usually your legs — don’t receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking.

PAD is often associated with the widespread accumulation of fatty deposits in your arteries (atherosclerosis), which may reduce blood flow to your heart and brain, as well as your legs.
Less commonly, blood vessel inflammation, injury to your limbs, or unusual anatomy of your ligaments or muscles may cause PAD.

SYMPTOM CHECKER

Signs and symptoms of PAD include:

• Painful cramping in your hip, thigh or calf muscles during an activity that goes away with rest (intermittent claudication)
• Leg numbness or weakness
• Coldness in your lower leg or foot, especially when compared with the other side
• Sores on your toes, feet or legs that won’t heal
• A change in the color of your legs
• Slower hair growth on your feet and legs and slower toenail growth
• Shiny skin on your legs
• No pulse or a weak pulse in your legs or feet
• Erectile dysfunction in men

Leg pain may vary widely from mild discomfort to debilitating pain. Severe pain can make it difficult for you to walk without stopping to rest or do other types of physical activity. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is the most common.

Factors that increase your risk of developing PAD include smoking, diabetes, obesity, high blood pressure, high cholesterol, and a family history of PAD. 

TREATMENT

The treatment has two major goals. The first is to manage symptoms, such as leg pain so that you can resume physical activities. The second is to stop the progression of atherosclerosis. You may be able to accomplish these goals with lifestyle changes, including exercise and a healthy diet. If lifestyle changes aren’t enough, you may need additional treatment.

Medications

Medications used to treat PAD include:

• Symptom-relief medications. The drug increases blood flow to the limbs both by preventing blood clots and by widening the blood vessels. It helps relieve symptoms such as leg pain.
• Medications to prevent blood clots. Because PAD reduces blood flow to your limbs, you’re at increased risk of blood clots. A blood clot can block an already narrowed blood vessel and cause tissue death. Your doctor may prescribe daily aspirin therapy or other medication to prevent blood clots.
• Medications to treat other conditions. Your doctor may prescribe medication to lower your cholesterol level, reduce high blood pressure, or treat diabetes that may accompany PAD.

Angioplasty and surgery

In some cases, procedures may be necessary to treat narrowed arteries that cause pain or symptoms such as leg numbness or weakness.

• Angioplasty. A small tube (catheter) is threaded through a blood vessel to the affected artery. There, a small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage, while at the same time stretching the artery to increase blood flow. Your doctor may insert a mesh framework (stent) in the artery to help keep it open.
• Bypass surgery. A surgeon creates a graft using a vessel from another part of your body or a blood vessel made of synthetic fabric. This technique allows blood to flow around (bypass) the blocked or narrowed artery.
• Thrombolytic therapy. If a blood clot is blocking an artery, a clot-dissolving drug is injected into your artery to break up the clot.

Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.