Peripheral Artery Disease: What You Need To Know

October 13, 2022

Peripheral artery disease may be one of the most significant health threats you don’t know about.

Most people are aware of coronary artery disease and the danger it represents to your heart. Peripheral artery disease (PAD) is a close cousin that affects 20 percent of Americans age 65 and older. Half of them have no idea they have the disease.

As with coronary artery disease, PAD is caused by atherosclerosis, the buildup of fatty plaque --made of cholesterol, calcium and cellular debris – in the arteries. Think of your body as a house with a plumbing system. Trouble arises whenever those pipes become blocked. In the case of PAD, it’s usually the legs that suffer from reduced blood flow. In worst case scenarios, the disease requires amputation of limbs and increases your risk for stroke and heart attacks.

Symptoms of Peripheral Artery Disease

One of the more frightening aspects of peripheral artery disease is that half of the people who have it don’t have any symptoms. This is often a slow-developing disease, with no obvious symptoms until arteries have narrowed by 60 percent of more.

Among the common symptoms:

  • Leg discomfort or pain. Often the pain grows more intense while walking and gets better with rest. It may occur in the calf, buttocks or thighs.
  • Leg numbness or weakness
  • Burning or aching in the feet and toes, particularly at night while resting
  • Redness in the skin
  • Frequent infections
  • Sores on the feet or toes that are slow to heal
  • Shiny skin on the legs
  • Slow toenail growth
  • Coldness in your lower leg or foot

Risk Factors of Peripheral Artery Disease

If you are at risk for coronary artery disease, then you also are at risk for PAD. The two diseases are so closely related that one-third of patients with heart disease also have peripheral artery disease.

Risk factors include:

  • Tobacco use (the greatest risk)
  • Diabetes
  • Age 65 or older
  • Being African American
  • Family or personal history of heart or blood vessel disease
  • High blood pressure
  • High cholesterol
  • Obesity
  • Kidney disease

Why You Should be Screened

Considerable work needs to be done to improve the screening rate for this disease. It’s sobering to realize that half of the people who reach the point of amputation were never screened for PAD. Early detection is critical to early treatment, which can save limbs and help avoid other complications, including stroke and heart attack.

If you notice any symptoms – particularly those that decrease your ability to function normally – talk with your doctor. There are several tests that can help diagnose and determine the severity of PAD, including:

Ankle/brachial index (ABI): This test uses blood pressure cuffs on your arms and legs to look for differences in blood pressure in your limbs. If you have PAD, the blood pressure in your legs may be noticeably lower.

Pulse volume recording (PVR): This test can diagnose PAD and help identify the location of the blockage. It uses a series of blood pressure cuffs on your legs to measure blood flow throughout the entire limb. Blood pressures are measured before and after exercise on a treadmill.

Vascular ultrasound: This noninvasive test uses sound waves to create images of your blood vessels and examine blood circulation.

Treatment for Peripheral Artery Disease

When PAD is detected early, there are more treatment options available. In the earliest stages, it may even be possible to reverse the disease with lifestyle changes.

The most important thing you can do is stop smoking. Dietary changes should focus on foods that are high in fiber and low in cholesterol. A regular exercise plan, particularly one that gets you out walking, also helps.

Medications that lower cholesterol and control blood pressure will reduce risk factors and help protect you from heart attack or stroke. Your doctor may also suggest a medication that helps you walk farther before leg pain flares up.

Surgical options – similar to those used for heart disease – may be considered in advanced cases resulting in severe pain and limited mobility. These include:

Balloon angioplasty: This procedure uses a miniature balloon, passed into your arteries through a catheter (a long, thin tube). When inflated, the balloon pushes against the plaque and widens the artery.

Stents: These tiny metal support coils are placed in your arteries by way of a catheter. These devices expand against the inner walls of the blood vessels to keep them open.

Atherectomy: A catheter with a tiny blade at the end is used to remove plaque from the artery walls.

Peripheral artery bypass surgery: This is like a heart bypass, where a healthy section of vein is used to bypass the blocked artery. The procedure may be needed in severe PAD cases.

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