Peripheral Arterial Disease

Peripheral artery disease, or PAD, happens when the blood vessels in your legs become narrowed or blocked, which reduces blood flow to your legs.

PAD is quite common, affecting up to 5% of adults and about 20% of folks over 65. In the U.S., around 10 million adults aged 40 and older have PAD, but it often goes undiagnosed.

Some things that can up your chances of getting PAD include:

• Being African American
• Being physically inactive
• Diabetes
• Family history
• Getting older, especially after 50
• High blood pressure
• High cholesterol
• Obesity
• Smoking

Many people with PAD don’t have symptoms, but some might experience:

• Changes in toenails or leg hair
• Coldness in the legs
• Erectile dysfunction
• Leg pain while walking (claudication)
• Numbness or weakness in the legs
• Pain in the hips, thighs, or calves after activities
• Skin changes or sores on the legs
• Weak or absent pulse in the legs

PAD often happens because of fatty deposits (plaques) building up in the arteries, a process called atherosclerosis. Other causes can include inflammation, injury, or radiation exposure.

Your healthcare provider will examine you and ask about your symptoms and medical history. They might check your pulse in the affected area, which can be weak or absent with PAD.

Tests for diagnosing peripheral artery disease may include:

• Angiography: This test uses special X-rays, MRI scans, or CT scans to look for artery blockages. Before taking images, dye is injected into a blood vessel to help the arteries show up clearly.
• Ankle-brachial index (ABI): A common test that compares blood pressure in the ankle with that in the arm. You may walk on a treadmill, and blood pressure readings are taken before and after to check artery health during exercise.
• Blood tests: These check for conditions related to PAD like high cholesterol, high triglycerides, and diabetes.
• Ultrasound of the legs or feet: This test uses sound waves to see how blood flows through blood vessels. It’s like taking a picture of the inside of your legs or feet to check if there are any blockages.

Treatment for peripheral artery disease aims to:

• Manage symptoms like leg pain to make exercise more comfortable.
• Improve artery health to lower the risk of heart attack and stroke.
• Treatments can involve lifestyle changes and sometimes medication.

Lifestyle changes are key, especially early on. If you smoke, quitting is super important to reduce complications. Regular exercise, like walking, can also make a big difference.

In some cases, procedures like angioplasty or surgery might be needed:

• Angioplasty and stent placement: Opens blocked arteries by using a balloon to widen them and putting a small tube (stent) to keep them open.
• Bypass surgery: Makes a detour around blocked arteries using a healthy blood vessel or a man-made one.
• Thrombolytic therapy: Breaks up blood clots blocking arteries by injecting a special drug directly into the artery.

An interventional radiologist, vascular surgeon, or interventional cardiologist specializes in diagnosing and treating PAD.