What Is Peripheral Artery Disease?
The narrowing or obstruction of the blood arteries that supply the legs with blood from the heart is known as Peripheral Arterial Disease (PAD) in the lower limbs. Atherosclerosis, or the accumulation of fatty deposits in the arteries, is the main cause of it. Although PAD can occur in any blood vessel, it tends to occur more frequently in the legs compared to the arms.
What Causes Peripheral Artery Disease?
The common cause of PAD is atherosclerosis. This issue arises when plaque, or fatty material, accumulates on the artery walls, narrowing the arteries. Additionally, the artery walls stiffen and lose their ability to dilate or broaden to permit increased blood flow when necessary.
Peripheral artery disease often presents with minimal or no symptoms. A few individuals get claudication or pain in the legs during walking.
As a result, when the leg muscles are working harder (as during exercise or walking), they are unable to receive adequate blood and oxygen. At times when the muscles are at rest, there might not be enough blood or oxygen if PAD gets severe.
What Are the Signs and Symptoms of Peripheral Artery Disease?
Muscle soreness or cramps in the arms or legs that start during exercise and stop after rest are indications of claudication. Most frequently, the calf is the site of pain. There is a slight to severe spectrum in the pain. Walking or engaging in other physical activities may be difficult if one experiences severe leg discomfort.
Other signs and symptoms of peripheral artery disease could be:
-
The feeling of coldness in the foot or lower leg, particularly in relation to the opposite side.
-
Weakness or numbness in the legs.
-
The legs or feet may not pulse at all or rather weakly.
-
Cramping that hurts in one or both hip, thigh, or calf muscles following strenuous activity like walking or climbing stairs.
-
Legs with glossy skin.
-
Variations in leg skin tone.
-
Reduced rate of toenail growth.
-
Sores that refuse to go away on the legs, feet, or toes.
-
Aching and cramping in the arms when knitting, writing, or performing other manual duties.
-
Erectile dysfunction.
-
Leg hair loss or sluggish hair growth.
-
Pulses in the feet that are reduced or missing.
What Are the Risk Factors for Peripheral Artery Disease?
Peripheral artery disease is far more likely to occur in people who smoke or have diabetes. The following are additional factors that raise the risk of peripheral artery disease:
-
Peripheral artery disease, heart disease, or stroke in the family history.
-
Elevated blood pressure.
-
Elevated cholesterol.
-
Elevations in homocysteine, an amino acid, raise the risk of coronary artery disease.
-
Growing older, particularly beyond 65.
-
Obesity (body mass index, greater than 30).
How to Diagnose Peripheral Artery Disease?
The patient's history, physical examination, and objective test results should all be considered while diagnosing PAD. One of the most critical aspects of history is a precise evaluation of the individual's walking capacity. Peripheral artery disease may be diagnosed with the following tests:
-
Blood Examinations: Blood tests are performed to screen for diseases like diabetes, high triglycerides, and high cholesterol linked to PAD.
-
Ankle-Brachial Index (ABI): This test is frequently used to identify PAD. It does this by comparing the blood pressure in the arm and ankle. Physicians might ask patients to take a stroll on a treadmill. Blood pressure measurements can be done both before and right after an exercise session to evaluate the arteries while walking.
-
Ultrasonography of the Feet or Legs: This test measures blood flow through blood vessels using sound waves. A unique kind of ultrasonography called Doppler ultrasound is utilized to identify clogged or constricted arteries.
-
Angiography: This test examines artery blockages using Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), or X-rays. A blood vessel is injected with dye (contrast) before imaging. In the test photographs, the dye makes the arteries easier to see.
How to Treat Peripheral Artery Disease?
Peripheral artery disease is treated with lifestyle modifications and occasionally medication.
Here are some strategies to manage PAD:
-
Strike a balance between training and recovery. Walk or engage in another activity until it hurts, then take breaks. Consult the healthcare professional first before beginning an exercise regimen.
-
Give up smoking. Smoking causes blood vessels to narrow, reduces the oxygen-carrying capacity of the blood, and raises the risk of blood clots.
-
Pay attention to the feet, particularly if one has diabetes. Put on appropriately fitting shoes. Inspect any wounds, scrapes, or injuries, and immediately contact a medical professional. Reduced circulation slows the healing process of tissues and increases their susceptibility to infection.
-
Ensure that the blood pressure is under control.
-
Consume a low-fat, low-cholesterol diet when the level of cholesterol is high.
-
If diabetic, watch the sugar levels in the blood and maintain appropriate levels.
Medications such as the following may be required to manage the disorder:
-
Antihypertensive Medications: Uncontrolled hypertension can harden and stiffen arteries. This may cause the blood flow to slow. A healthcare professional may recommend medication to lower the blood pressure level if it is elevated.
-
Statin Medications: Patients with peripheral artery disease are frequently prescribed statins. Statins aid in lowering bad cholesterol and artery-clogging plaque.
-
Antiplatelet Medications: Aspirin or another drug, such as Clopidogrel, may be administered to stop blood clotting.
-
Pain Medications: Cilostazol is a medication that expands blood arteries and thins blood. It improves circulation to the extremities. Specifically, the medication helps relieve peripheral artery disease patients' leg pain.
Treatment options for peripheral artery disease that is producing claudication may include surgery or angioplasty in certain cases:
-
Implantation of Stents and Angioplasty: This technique aims to clear blocked arteries. It is capable of simultaneously diagnosing and treating a clogged vessel. A thin, flexible tube called a catheter is inserted into the constricted portion of the artery by the medical professional. A small balloon is inflated to enhance blood flow and expand the clogged artery. To maintain the artery open, a tiny wire mesh tube known as a stent may be inserted into it.
-
Bypass Surgery: Using a synthetic blood vessel or a blood vessel in good condition from another body area, the surgeon makes a way around the clogged artery.
-
Thrombolytic Medication: An intravenous clot-dissolving medication may be administered directly into the artery if a blood clot obstructs it.
What Are the Potential Complications of Peripheral Artery Disease?
Possible complications include:
-
Emboli or blood clots that obstruct tiny arteries.
-
Heart disease.
-
Impotence.
-
Open sores.
-
Gangrene.
-
Amputating the afflicted limb or foot can be necessary.
Conclusion
Peripheral artery disease occurs when the arteries get narrowed by plaque deposition. Early diagnosis of PAD is crucial since it raises the risk of heart attack and stroke. The majority of leg PAD cases are manageable without surgery. Surgery is no longer the only option for treating severe cases of symptoms; nevertheless, angioplasty and stenting techniques are increasingly being employed in its place.
