| Peripheral Artery Disease (PAD) (Peripheral Vascular Disease) Definition Peripheral artery disease (PAD) is a condition in which the arteries that carry blood to areas outside the heart become narrow or clogged. This affects blood circulation, mainly in the arteries leading to the legs and the feet. Causes Peripheral artery disease is usually caused by a gradual buildup of plaque in the arteries (atherosclerosis.) Other causes include blood clot or embolism, congenital heart disease, inflammation of the blood vessels (vasculitis,) aortic dissection, and rarely, tumor. Risk Factors A risk factor is something that increases your chance for getting a disease or condition. Risk factors for PAD include the following: Age over 50 Family history of cardiovascular disease Having any of the following conditions: Diabetes, High cholesterol, Hypertension, Obesity, Sedentary lifestyle Symptoms PAD may produce no symptoms. When they do occur, symptoms or signs may occur in the following areas: Cerebrovascular system (carotid and vertebral arteries leading to the brain) Stroke, which has the following symptoms: Blurry, dimming, or no vision Difficulty swallowing, talking, or comprehending others Dizziness, falling, or loss of consciousness Weakness or numbness on one side of the body Kidneys (renal arteries) Renal artery stenosis, which often has no symptoms, but can lead to: Hypertension Kidney failure Lower extremities, or legs (iliac, femoral, popliteal arteries) Burning or aching pain in feet or toes Cold legs or feet Color change in legs or feet Diminished ability to walk Gangrene, in advanced cases Leg or hip pain when walking (claudication) Loss of hair on legs Numbness, tingling or weakness in the legs Intestines (mesenteric arteries) Mesenteric arterial disease: Intestinal gangrene, can lead to death Severe pain Weight loss Diagnosis The doctor will ask take your medical history and perform a physical exam. The following tests are used to diagnose PAD: Doppler ultrasound – a test that uses sound waves to examine the inside of the body, in this case the size and shape of arteries X-ray angiography – x-rays taken after a dye is injected into the arteries; allows the doctor to look for abnormalities in the arteries Magnetic resonance imaging (MRI) – magnetic waves used to make pictures of the inside of the body, in this case the arteries. Treatment People who have PAD have an increased risk of death from stroke and heart attack, in part due to the risk of blood clots breaking off from the affected arteries. Treatment of PAD may include the following: Medication – anti-thrombotics (anti-platelet agents and anti-coagulants) help prevent blood from clotting. Angioplasty – a tube (catheter) is used to dilate the arteries. A cylindrical device (stent) is implanted in the narrowed artery and expands and opens it. Bypass surgery – a vein from another part of the body or a synthetic blood vessel is used to bypass the diseased part of the artery. Atherectomy – the diseased artery is cut open and the fatty deposit is removed so that blood can flow more easily. Prevention The following behaviors can help prevent PAD: Achieve and maintain a healthful weight. Don’t drink alcohol, or drink in moderation (no more than 2 drinks per day for men and 1 drink per day for women) Eat a healthful diet. Exercise regularly, particularly aerobic exercise. If you have any of the following conditions, keep them under control: Depression, Diabetes, High blood pressure, High cholesterol, particularly LDL cholesterol, and triglycerides If you smoke, quit. See your health care provider regularly. Try to reduce your stress levels. Last reviewed: February 2003 by Rhonda Kaufman, MD. |
