You are aware of the oxygenated blood carriers of the body the arteries. Some time due to pathology a plaque-like substance gets deposited in the lumen of peripheral arteries, this is called peripheral arterial disease. The disease leads to narrowed arterial lumen which in turn raises the pressure with which the blood flows. If the lumen is completely choked, the organ may not get any blood supply. The plaque may burst and move to smaller arteries blocking them completely.
According to an International organization, the prevalence of peripheral artery disease in India is estimated at 41 to 54 million. Critical limb ischemia afflicts 4.2 to 6.2 million people.
The main reason for PAD is Type 2 diabetes, smoking, and hypercholesterolemia that initiate plaque built up in the arteries.
- Asymptomatic until severe
- Calf pain that gets worse with exerting and betters with rest
- Non-healing wounds
- Cold extremity
As like most of the other disorders, its direct cause is unknown, what’s known is that there is damage to the inner layer of the artery, which may be because of –
- High cholesterol
- High triglycerides
- High blood pressure
- Smoking and other tobacco goods
- Inflammation from diseases and their metabolites like rheumatoid arthritis, lupus or infections, etc.
- Family history
- Lack of physical activity
- Unhealthy dietary intake
- Ankle-brachial index where the blood pressure of arm and leg is compared, blood pressure higher in the upper extremity is a sign of PAD
- Ultrasound Doppler or Colour Doppler
PAD not only requires certain medications but also a major and sustainable lifestyle modification that includes –
- An approach of the diet with:
- Low sodium
- High potassium
- Emphasizing fruits, vegetables
- And low‐fat dairy products
- Low sugar, no canned food
- Lose weight and maintain it all through. This can be achieved by working on your body mass index or waist-hip ratio.
- Reduce alcohol intake.
- A regimen of mix physical activities like yoga, pranayama, and cardio exercises.
- Quitting smoking – Has a major effect on controlling PAD.
- Medications for blood sugar, blood pressure, and cholesterol needs to be taken as prescribed, maintaining vitals is important for controlling PAD.
- Medication for blood thinning.
- Percutaneous Intervention and Surgical Management.
- Balloon Angioplasty – is a minimally invasive procedure where a tube is introduced into the affected artery from which a balloon is inserted and inflated into the artery widening it and preventing any further PAD. Sometimes, a stent accompanies the balloon for the same purpose, after which the balloon is withdrawn.
- Arterial Bypass – Due to plaque deposition in arteries because of hypercholesterolemia and dyslipidemia the circulation is blocked. The arterial bypass is a surgical procedure where blood vessels from another area are grafted collaterally to the affected artery so that the blockage is bypassed and circulation to the area is restored.
Early diagnosis and prompt treatment go a long way. Staying in touch with your clinician, monthly check-ups will keep you up to date. A person with PAD lives a healthy life provided they adapt to a healthier lifestyle and take timely prescription medication.
Dr. Anand Kumar Pandey, Director & Senior Consultant – Cardiology – Adult, Dharamshila Narayana Superspeciality Hospital, Delhi