Peripheral artery disease (PAD) is a disease of the vessels that supply blood to the arms and legs. Most often, PAD refers to disease affecting the blood vessels that supply the legs. PAD results from a lack of sufficient blood flow to nourish the tissues and muscles. PAD is often overlooked and left untreated. Many people think its symptoms are just part of natural aging. However, medical experts warn that people with PAD have an increased risk of heart attack or stroke.
Symptoms.
People with PAD may experience mild or no symptoms. A key symptom of PAD is a periodic pain or cramping called intermittent claudication (IC). It most often affects the muscles in the calf, thigh, or buttock. IC often occurs with walking, even over a short distance. IC is relieved with rest. As PAD worsens, people can experience pain even when not walking, called rest pain. If not treated, rest pain can progress and cause serious medical complications. Such complications may even require doctors to amputate affected limbs.
Causes.
PAD can develop from atherosclerosis, a condition involving a hardening, thickening, and loss of elasticity in the artery walls (see Arteriosclerosis is). These conditions narrow the artery, limiting blood flow through the vessel.
Diabetes and smoking are major risk factors for developing PAD. Diabetes is a disease in which blood sugar levels are abnormal (see Diabetes ). Other risk factors are high blood pressure and high blood levels of cholesterol, a fatty substance. Being overweight and living a sedentary (inactive) lifestyle also contribute to the development of PAD.
Diagnosis and treatment.
Doctors diagnose PAD using a measurement called the ankle-brachial index (ABI). The ABI is the ratio of the blood pressure in the ankle compared with that in the arm. An ABI below 0.9 indicates possible PAD. The lower the ABI, the more severe the disease. A test called an arterial duplex scan is used to help determine the severity and location of PAD. This test uses ultrasound (high-frequency sound waves) to image any narrowing of the arteries in the arms and legs.
Treatment of PAD begins by addressing the underlying risk factors, such as smoking and excess weight. A program of regular walking often helps improve PAD symptoms. Doctors may also prescribe medications that improve blood flow. Some people with PAD benefit from angioplasty. In this procedure, a balloon is inserted in the artery to open it (see Angioplasty ). An expandable metal device called a stent can be inserted to keep the blood vessel open. Some people with severe PAD may require an operation to bypass a narrowed portion of blood vessel.
