Peripheral Artery Disease (PAD) A common circulatory problem in which narrowed arteries reduce blood flow to your limbs

Peripheral artery disease (PAD) is the reduced blood flow in the limbs due to narrowed arteries. This disease is marked by mild to severe pain of the legs, while walking (claudication).

Peripheral artery disease may be a sign of accumulation of fatty deposits in the arteries of the body. This condition will lead to reduced flow of blood to the heart and brain. The main cause of peripheral artery disease is not known, however the incidence of PAD can be reduced by quitting smoking, exercising and having a healthy diet.

Symptoms

Numbness of the legs, hair loss on the legs, slow growth of toe nails, erectile dysfunction, sores on legs and toes, lower leg coldness, and general weakness may confirm the presence of peripheral artery disease. Peripheral artery disease is usually seen in people who are over 70, and those with a history of diabetes and high BP. People who are obese are also susceptible to peripheral artery disease.

Causes

Peripheral artery disease is caused by atherosclerosis, a condition which is characterized by fatty deposits (plaques) that build up in the artery walls. Atherosclerosis results in reduced blood flow in the arteries.

Risk Factors & Complications

People who smoke are at a greater risk of developing peripheral artery disease. People with a history of diabetes, high BP, and peripheral artery disease can be included in the risk group. Also, people who smoke or have diabetes have a greater risk of peripheral artery disease.

Peripheral artery disease may lead to complications viz critical limb ischemia, when injuries or infections progress and can cause tissue death (gangrene) leading to leg amputation. Peripheral artery disease may also lead to stroke and heart attack due to blockage of arteries by fat deposits. The blocking of arteries is not limited to the legs. As blocking of the arteries that supply blood to the heart may lead to heart and brain stroke.

Test & Diagnosis

The doctor initially makes a physical examination that includes checking the pulse below the narrowed area of the artery, condition of wounds at the area of blood flow restriction, and the blood pressure of the affected limb.

On confirmation of Peripheral artery disease, the doctor recommends for Ankle-brachial index (ABI), a common test for the diagnosis of Peripheral artery disease. The ABI test compares the blood pressure in the ankle with that in the arm. Treadmill walk is also advised to take readings, and capture the severity of the narrowed arteries during walking.

Doppler ultrasound helps the doctor to evaluate the blood flow through the blood vessels and identify blocked arteries. Angiography helps doctors to know the flow the blood through the arteries. Imaging techniques like x-ray, MRA and CTA are used to trace the flow of blood along the arteries.

Catheter angiography, a complicated procedure also helps doctors to diagnose and treat the condition of peripheral artery disease. A catheter is guided to the affected area, the narrowed blood vessel is widened, and medicine administered for blood flow improvement. Blood testing is also recommended to measure the levels of cholesterol and triglycerides.

Treatment

The treatment for Peripheral Artery Disease (PAD) is two way – manage the symptoms and stop its progression. Few changes in the lifestyle viz quitting smoking can lead to reduced risk of peripheral artery disease. Medications include cholesterol-lowering drugs that help to reduce heart risk and stroke.

High blood pressure medications help to reduce the diastolic or systolic blood pressure. Blood sugar and blood clots are controlled by proper medications. Surgical procedures for peripheral artery disease include angioplasty, bi-pass surgery and thrombolytic therapy.