What is Peripheral Arterial Disease?
A common cardiovascular condition in which restricted arteries limit blood flow to your limbs is peripheral artery disease (also known as peripheral arterial disease). When you have peripheral artery disease (PAD), the blood supply to your legs or arms generally your legs is insufficient to keep up with demand. This may result in symptoms such as leg soreness when walking (claudication). Peripheral artery disease is also a symptom of fatty deposit development in your arteries (atherosclerosis). This disorder can cause artery narrowing and limit blood flow to your legs and, in rare cases, your arms. Exercising, eating a nutritious diet, and quitting cigarettes in any form are typically effective ways to cure peripheral artery disease.
Symptoms
When many patients with peripheral artery disease have no or just minor symptoms, some have leg pain while walking (claudication). Claudication symptoms include muscular soreness or cramping in your legs or arms that are induced by exercise but go away after a few minutes of rest. The pain's location is determined by the position of the obstructed or constricted artery. The most prevalent place is calf soreness. The intensity of claudication ranges from minor discomfort to incapacitating agony. Severe claudication can make it difficult to walk or engage in other forms of physical exercise.
Signs and symptoms of peripheral artery disease include:
- Cramping in one or both hips, thighs, or calf muscles after doing specific tasks, such as walking or ascending stairs
- Numbness or weakness in the legs
- Coldness in your lower leg or foot, particularly when contrasted to the other side
- Unhealing wounds on your toes, foot, or legs
- A difference in the color of your legs
- On your feet and legs, you may experience hair loss or decreased hair growth.
- Hands or arms that become easily fatigued
- Toenail development is slowed.
- Legs with gleaming skin
- You have no pulse or a faint pulse in your legs or feet.
- Male erectile dysfunction
- Aching and cramping in your arms when crocheting, writing, or performing other manual chores
Pain may occur even while you are at rest or lying down if peripheral vascular disease advances. It might be severe enough to keep you up at night. Walking about your room or dangling your legs over the side of your bed may provide temporary relief.
Causes
Atherosclerosis is a common cause of peripheral artery disease. Atherosclerosis is characterized by the accumulation of fatty deposits on the arterial walls, which reduces blood flow. Although most talks about atherosclerosis center on the heart, the disease may and often does impact arteries throughout the body. Peripheral artery disease happens when it arises in the arteries that carry blood to your limbs. Peripheral artery disease can also be caused by blood vessel inflammation, limb injury, atypical ligament or muscle structure, or radiation exposure.
Diagnosis
Some of the tests your doctor may use to make a diagnosis include:
During a physical exam, your doctor may detect PAD symptoms such as a weak or absent pulse below a narrowed area of your artery, whooshing sounds over your arteries that can be heard with a stethoscope, evidence of poor wound healing in the area where blood flow is restricted, and low blood pressure in your affected limb.
Ankle-Brachial Indices (ABI)
This is a standard test for determining PAD. It compares your ankle blood pressure to your arm blood pressure.
Your doctor will use a standard blood pressure cuff and a specific ultrasonography instrument to measure blood pressure and flow to obtain a blood pressure reading.
Ultrasound
Doppler ultrasonography, for example, can assist your doctor measure blood flow through your blood vessels and discovering blocked or restricted arteries.
Angiography
This test, which uses a dye injected into your blood vessels, lets your doctor see blood flow through your arteries as it happens. Imaging methods, including X-rays, magnetic resonance angiography (MRA), or computed tomography angiography, can be used by your doctor to track the passage of the dye.
Catheter angiography
Catheter angiography is an invasive treatment that includes inserting a short hollow tube (catheter) into an artery in your groin and injecting dye into the afflicted region. This sort of angiography enables your doctor to treat a clogged blood artery while it is still being diagnosed. Your doctor can enlarge a blood artery after locating the restricted location by inserting and inflating a small balloon or by delivering medicine that enhances blood flow.
Blood tests
A blood sample can be used to test your cholesterol and triglycerides as well as to screen for diabetes.
Treatment
The primary aims of treatment for peripheral artery disease are as follows:
- Manage symptoms like leg discomfort so you may continue physical activity.
- Reduce your risk of heart attack and stroke by halting the growth of atherosclerosis throughout your body.
- You may be able to achieve these goals with lifestyle adjustments, especially if you are diagnosed with peripheral artery disease early enough. If you smoke, the single most essential thing you can do to lower your chance of issues is to quit. Walking or doing another exercise regularly according to a program, referred to as supervised exercise training, can significantly improve your symptoms.
- If you have signs or symptoms of peripheral artery disease, you will almost certainly require extra medical attention. Your doctor may advise you to take medication to avoid blood clots, decrease blood pressure and cholesterol, and manage pain and other symptoms.
Medications
- Medication for decreasing cholesterol. To reduce your risk of heart attack and stroke, you may take a cholesterol-lowering medication known as a statin.
- Lowering low-density lipoprotein (LDL) cholesterol, or "bad" cholesterol, to less than 100 milligrams per deciliter (mg/dL) or 2.6 millimoles per liter (mmol/L) is the objective for persons with peripheral artery disease. If you have additional major risk factors for heart attack and strokes, such as diabetes or prolonged smoking, the objective is considerably lower.
- Medication for high blood pressure. If you have high blood pressure, your doctor may prescribe drugs to help you manage it.
- Your treatment objective for blood pressure should be less than 130/80 millimeters of mercury (mm Hg). This is the recommendation for anyone suffering from coronary artery disease, diabetes, or chronic renal disease. Aiming for 130/80 mm Hg is also the aim for healthy persons 65 and older, as well as healthy adults younger than 65 who are at a 10% or greater risk of developing cardiovascular disease in the following ten years.
- Medication is used to regulate blood sugar levels. Controlling your blood sugar levels becomes much more critical if you have diabetes. Discuss your blood sugar objectives with your doctor, as well as the measures you need to take to accomplish these goals.
- Preventing blood clots medications- Because peripheral artery disease is associated with decreased blood flow to your limbs, it is critical to increase that flow.
- Your doctor may advise you to take aspirin every day or to take another medicine, such as clopidogrel (Plavix).
- Medications for symptom alleviation - Cilostazol enhances blood flow to the limbs by both keeping the blood thin and expanding the blood vessels. It is very useful in treating leg discomfort in persons with peripheral artery disease. Headache and diarrhea are common adverse effects of this drug.
- Pentoxifylline is an alternative to cilostazol (Pentoxil). This medicine has few side effects, however, it does not function as effectively as cilostazol.
Angioplasty And Surgery
In some circumstances, angioplasty or surgery may be required to treat claudication caused by peripheral arterial disease: Angioplasty. A catheter is passed into a blood vessel to the afflicted artery during this treatment. A tiny balloon at the catheter's tip is inflated to flatten the plaque into the arterial wall and reopen the artery while stretching the artery open to promote blood flow. To keep the artery open, your doctor may place a mesh tube (stent) in it. This is the same technique used by surgeons to open heart arteries. Bypass surgery is performed. Your doctor may use a blood vessel from another area of your body or a synthetic vessel to build a passage around the blocked artery. Blood can bypass the blocked or constricted artery with this approach. Thrombolytic treatment If a blood clot is blocking an artery, your doctor may inject a clot-dissolving medicine into the artery at the clot's location to break it up.
Risk Factors
- Smoking
- Diabetes
- Overweight (a body mass index over 30)
- Blood pressure is too high.
- High levels of cholesterol
Increasing age, particularly after the age of 65 or after the age of 50 if you have atherosclerosis risk factors. A history of peripheral artery disease, heart disease, or stroke in the family. Homocysteine levels are high, which is an amino acid that helps your body create protein and build and maintain tissue. People who smoke or have diabetes are more likely to develop peripheral artery disease owing to decreased blood flow.
Complications
If your peripheral artery disease is caused by plaque accumulation in your blood arteries, the following are the risk of developing:
Critical Limb Ischemia- This disorder begins with open wounds that do not heal, an injury, or an infection in your feet or legs. When injuries or infections continue and cause tissue death, critical limb ischemia ensues, potentially necessitating amputation of the afflicted limb.
A Stroke & Heart Attack- Atherosclerosis that produces the symptoms of peripheral arterial disease is not restricted to your legs. Fat deposits can also form in the arteries that provide blood to your heart and brain.
