Peripheral Artery Disease (PAD)

Peripheral artery disease, also called peripheral arterial disease, is a common circulatory problem where narrowed arteries reduce blood flow to your limbs.

When you develop peripheral artery disease (PAD), your extremities — usually your legs — don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking. Peripheral artery disease is also likely to be a sign of a more widespread accumulation of fatty deposits in your arteries. This condition may reduce blood flow to your heart and brain, as well as your legs.

PAD signs and symptoms include:

• Painful cramping in one or both of your hips, thighs or calf muscles after certain activities, such as walking or climbing stairs.
• Leg numbness or weakness.
• Coldness in your lower leg or foot, especially when compared with the other side.
• Sores on your toes, feet or legs that won't heal.
• A change in the color of your legs.
• Hair loss or slower hair growth on your feet and legs.
• Slower growth of your toenails.
• Shiny skin on your legs.
• No pulse or a weak pulse in your legs or feet.
• Erectile dysfunction in men.

Causes and risk factors

Factors that increase your risk of developing peripheral artery disease include:

• Smoking
• Diabetes
• Obesity (a body mass index over 30)
• High blood pressure
• High cholesterol
• Increasing age, especially after 50
• A family history of peripheral artery disease, heart disease or stroke.

People who smoke or have diabetes have the greatest risk of developing peripheral artery disease due to reduced blood flow.

Treatment

Treatment for peripheral artery disease has two major goals:

• Manage symptoms, such as leg pain, so that you can resume physical activities.
• Stop the progression of atherosclerosis throughout your body to reduce your risk of heart attack and stroke.

You may be able to accomplish these goals with lifestyle changes, especially early in the course of peripheral artery disease. If you smoke, quitting is the single most important thing you can do to reduce your risk of complications.

If you have signs or symptoms of peripheral artery disease, you likely will need additional medical treatment. Your health care provider may prescribe medicine to prevent blood clots, lower blood pressure and cholesterol, and control pain and other symptoms.

For more information, schedule an appointment with the Vascular Medicine Clinic.

Lifestyle changes

Treatment for peripheral disease usually involves lifestyle changes and, if necessary, drugs and certain medical procedures.

Committing to these healthy lifestyle changes can go a long way toward promoting healthier arteries:

• Quit smoking
• Eat healthy foods
• Exercise regularly
• Lose excess weight
• Reduce stress

Angioplasty and stent placement

An angioplasty is a procedure used to open clogged arteries. Angioplasty uses a tiny balloon catheter that is inserted in a blocked blood vessel to widen it and improve blood flow.

Angioplasty is often combined with the placement of a small wire mesh tube called a stent. The stent props the artery open, decreasing its chance of narrowing again. Most stents are coated with medication to keep your artery open.

Atherectomy

An atherectomy is a procedure to remove the plaque from the blocked or clogged artery. Removing the plaque makes the artery wider, improving blood flow in and out of the heart.

An atherectomy may be performed on patients who have hard plaque or for patients who already have had an angioplasty or stent placement.