Peripheral Artery Disease

Peripheral artery disease (PAD) also known as the peripheral arterial disease is a medical condition where the arteries get narrowed and can’t carry much-needed blood to other parts of the body like arms and legs. It’s a form of peripheral vascular disease. When a person develops PAD, their legs don’t receive enough blood flow to keep up with the demand. This can cause leg pain while walking, which is the most notable symptom. If a person is suffering from PAD they’re more likely to have a widespread accumulation of fatty deposits in their arteries (atherosclerosis). This condition may be reducing blood flow to the heart and brain, as well as the legs. PAD is more commonly seen in people who are 65 or older but can occur at any age. Smoking, high BP, high cholesterol or triglycerides, diabetes, kidney failure and obesity increases the risk of PAD.

Causes

The fat and cholesterol in the bloodstream form plaque which builds up in the arteries. They make the arteries harder and narrower. This condition is known as atherosclerosis, which is the most common cause of . The common risk factors leading to PAD are –

Age (over 50)
Diabetes
High cholesterol
High blood pressure
Obesity
Not being active
Smoking

Symptoms

Claudication also known as muscle pain or cramping due to reduced blood flow to the legs is common in PAD. Patients usually feel it when they walk or climb stairs, but it stops as soon as they take some rest.

It can affect different muscle groups, including:

Buttock and hip
Calf (most common)
Foot (less common)
Thigh

Some people have a sense of burning or numbness. In an advanced form of peripheral artery disease, the toes or feet might hurt even while the person is resting.

The other symptoms of PAD include –

Changes in the colour of the legs
Erectile dysfunction
Leg weakness
Legs that are cooler than the arms
Loss of hair on the legs
Fainter pulse in the feet
Shiny skin on the legs
Slow toenail growth
Wounds or sores on the toes or feet that don’t heal well

Diagnosis

The doctor will start the diagnosis with a physical examination to look for signs of PAD. They’ll check the blood flow in the legs and feet and listen for a whooshing sound from the arteries in the legs.

They might ask the patient to take the following tests which include –

Ankle-branchial index – For comparing the blood pressure in the lower leg and upper arm of the patient.
Blood Tests – To check risk factors like diabetes and high cholesterol.
Ultrasound – To check blood flow and find blocked arteries.
Angiogram – Where a needle is inserted to put dye into the patient’s bloodstream before taking an X-ray to find blocked arteries.

Treatment

The first line of treatment of PAD consists of aggressively managing the risk factors with making major lifestyle changes and medications. Changing the current lifestyle and adopting healthy living habits like quitting smoking, controlling blood pressure and cholesterol, controlling diabetes, losing weight and having a strict exercise program can significantly improve the symptoms of PAD in many cases. In serious cases, advanced treatment modalities like a balloon angioplasty, stent placement or surgical bypass are introduced to effectively improve the blood flow to the damaged leg.

Prevention

To avert a condition like PAD, major lifestyle changes have to be made. Which include –

Abstaining from tobacco use. For people who smoke, they need to find a smoking cessation program that will help them quit.
Exercising regularly will not only keep PAD but also other medical conditions at bay.
Always take prescribed medications given by the doctor to control high BP, high cholesterol or triglycerides, diabetes and kidney failure.
Losing weight helps to take the load of the muscles while walking.
Eat a balanced, low-sodium, low-fat diet.

Dr. Robbie George | Chief of Vascular & Endovascular Surgery | Mazumdar Shaw Medical Center, Bommasandra, Bangalore

Narayana Health