Peripheral artery disease (PAD) is a condition that occurs in the arteries of the circulatory system. Healthy arteries promote the steady flow of blood. If the arteries become narrowed or blocked, blood cannot get through, causing damage to tissues or organs.
As PAD usually affects the legs, the symptom is typically pain or cramping in the affected leg(s), which is triggered by activity such as walking and subsides when the leg is at rest.
Other symptoms may include:
A tingling sensation in the affected limb(s)
Weakness in the affected limb(s)
A weak or absent pulse in the affected limb(s).
If severe enough, PAD can cause gangrene (tissue death), and a sore or ulcer that will not heal may develop on the foot.
Atherosclerosis is the cause of PAD, which is due to BOTH cholesterol and inflammation. It is caused by plaque that gradually builds up in arteries over time, causing them to narrow, and reducing blood flow. Plaque is composed of a variety of substances, including cholesterol, calcium, and inflamed cells. When plaque ruptures, it releases these substances into the bloodstream, which leads to the formation of a blood clot inside the artery.
Factors that increase a person’s risk for PAD include:
Smoking
Hyperlipidemia or lipid disorders - High levels of cholesterol in the blood can increase the risk of plaque buildup.
Hypertension (high blood pressure) - uncontrolled high blood pressure can result in hardening and thickening of the arteries.
Diabetes
Male gender
Advanced age
Obesity and lack of exercise
Alcohol and drug abuse
Your healthcare provider may hear a “bruit” with their stethoscope. A “bruit” is the name for the “whooshing” sound caused by turbulent blood flow in a narrowed artery.
In addition to taking a detailed medical history, listening to the patient describe symptoms, and conducting a physical exam, the healthcare provider may also recommend:
Ankle Brachial Index (ABI) – using a traditional blood pressure device and ultrasound, blood pressures are measured compare the blood pressure in a patient’s arms and legs.
Duplex Ultrasound – painless, noninvasive test where soundwaves are used to create pictures of the inside of the arteries and allows doctors to measure the speed of blood flow through them. These are done in our offices.
Arteriogram – Also called an “angiogram,” contrast material (or “dye”) is injected into an artery, then pictures are taken (MRI, CT scan, or x-ray). This produces detailed images that can show narrowing or blockages. These are done outside of our offices at a radiology facility and/or hospital.
How PAD is treated depends on the patient’s age & symptoms, the degree of narrowing, and the status of the affected blood vessels.
Medication such as aspirin or other antiplatelet medicines can help stabilize plaque and reduce risk of blockage.
Cholesterol medication to lower the amount of cholesterol in the blood, especially low-density lipoprotein (LDL, or the “bad” cholesterol). Also helps to stabilize plaque and reduce risk of blockage.
Sometimes more aggressive treatment is needed to restore and improve blood flow to the brain. These option might include:
Angioplasty and Stenting - During this non-surgical procedure, a balloon attached to a small catheter is inflated within an artery to flatten the plaque against the artery wall, increasing the artery's diameter. In most cases, a metal-mesh tube called a stent is expanded and left inside the artery to support the expansion and maintain blood flow.
Thrombolysis - During this non-surgical procedure, a clot is broken down with specialized catheters that either mechanically break it up or directly deliver drugs to dissolve it.
Thrombectomy - During this non-surgical procedure, a physician inserts a balloon catheter past the site of the blood clot, inflates it, and removes the balloon, pulling the clot with it.
Bypass Surgery - a surgical procedure performed by vascular surgeons outside of Virginia Heart. Surgeon uses other blood vessels from the legs to create new routes for blood to go around blockages
