Peripheral artery disease (PAD) is caused by a blockage, narrowing or hardening of the arteries in the legs. This may be commonly referred to as atherosclerosis.
Your arteries deliver blood, rich in oxygen and other nutrients, from your heart to your head, organs and limbs (arms and legs). Plaque is also found in the blood, made up of fat, cholesterol, calcium, fibrous tissue and other substances. Over time, plaque can build up in the arteries and cause a blockage, leading to atherosclerosis, which is more commonly known as a “hardening of the arteries”.
Clogged arteries significantly reduce the amount of blood that can flow through them. The reduction in oxygen-rich blood to the organs, head and extremities can lead to a number of potentially serious conditions.
Patients with peripheral artery disease are at greater risk for limb loss, as well as heart attack and stroke.
Symptoms of Peripheral Artery Disease
Plaque buildup in the legs may not always cause symptoms, so many people can have PAD and not know it. The most common symptoms for PAD are:
- Claudication, which is leg pain and/or tiredness in the legs that gets worse with physical activity but goes away during rest.
- Sores or wounds on the toes, feet, or legs that heal slowly, poorly or not at all (occasionally called diabetic foot or leg ulcers).
- Color changes in the skin of the feet (often paleness or blueness).
- Differences between the temperature of one leg versus the other.
- Poor toenail growth and/or decrease in hair growth on the toes or legs.
Learn more about the symptoms of P.A.D.
Risk Factors For PAD
Most patients who have peripheral artery disease have one or more conditions or habits that raise the risk for heart disease: smoking, diabetes, high blood pressure and/or high cholesterol.
- PAD is most common in adults over the age of 50
- Patients who smoke or have history of smoking are 4X more likely to develop PAD
- One in every three people over age 50 with diabetes is likely to have PAD
- High blood pressure and high cholesterol increase the risk for developing peripheral arterial disease
- History of heart attack, stroke or vascular disease.
- African Americans are twice as likely to have PAD
Learn more about the risk factors for PAD
How We Diagnose Peripheral Artery Disease
The initial diagnostic tests for PAD are quick, painless and non-invasive. Generally, the first test is an ankle brachial index (ABI), which involves placing blood pressure cuffs on the arms and legs to compare the blood pressure of each.
We also perform an ultrasound examination, considered to be the gold standard diagnostic evaluation of the arterial system. This test allows our doctors to see how blood is flowing through the vessels as well as the speed and direction of blood flow.
If we receive abnormal results from the initial diagnostic testing, our doctors may perform an angiography, which is an x-ray of the arteries. This examination is conducted in our outpatient centers under light anesthesia.
Learn more about how we diagnose PAD
Treatment for PAD
Our primary goal in treating peripheral artery disease is to reduce painful symptoms and improve quality of life and mobility, and prevent heart attack, stroke or limb loss. Generally a combination of three approaches will yield the best results. These include making lifestyle changes, medication and intervention/surgical procedures.
If you are diagnosed with PAD the most important thing you can do is quit smoking. Next, adopt a healthy diet and work with your primary care physician to reduce high blood pressure, cholesterol and blood glucose levels. Exercise is another important step in reducing symptoms of PAD.
Our doctors may recommend to your primary care physician that you be prescribed one or more medications which can be used to lower high blood pressure, control diabetes, prevent formation of blood clots and reduce leg pain when walking.
Intervention / Surgical Procedures
At the Center for Vascular Medicine, we specialize in non-invasive and minimally invasive procedures to open the arteries and improve blood flow. These procedures include:
- Laser Atherectomy - A relatively new technique offered at Center for Vascular Medicine, which reestablishes blood flow through narrowed or blocked arteries. The laser is used during angiographic procedures with minimally invasive techniques.
- Angioplasty - This technique is used to open blocked arteries by inflation of a balloon catheter. This technique is also utilized in the angiography suite, frequently in conjunction with both the laser atherectomy and stenting.
- Stenting - The doctor will insert a cylindrical, metal wire, mesh tube into the artery in order to keep the blood flow channel open. This technique is often combined with the laser atherectomy and angioplasty.
Learn more about our surgical treatments for PAD