PAD

PERIPHERAL ARTERIAL DISEASE (PAD)

What is peripheral arterial disease?

Peripheral arterial disease (PAD) or peripheral vascular disease (PVD) occurs when there is a blockage in the blood vessels that significantly decreases blood flow to the limbs, usually the legs. The blockage can be caused by inflammation or a clot, but it is most commonly caused by atherosclerosis, which is a condition of hardened and narrowed arteries caused by fatty deposits called plaques. Atherosclerosis is typically a condition that affects blood vessels throughout the body, and places the patient at increased risk for heart attack and stroke.

Decreased blood flow decreases the amount of oxygen available to the tissues, which can lead to pain, non-healing ulcers and infections in the limbs and ultimately tissue death called gangrene. If untreated, the affected limb may need to be amputated.

Risk Factors:

  • Smoking
  • Diabetes
  • Increasing age
  • Family history of vascular disease, including heart attack or stroke
  • Inactive lifestyle
  • Obesity
  • Hypertension
  • High cholesterol

Symptoms:

  • Claudication, or painful leg cramps that occur when walking
  • Numbness, tingling, weakness, or pain in feet or legs
  • Sores or wounds on feet or legs that do not heal
  • Cold feet or legs.
  • Blue or pale feet or legs.
  • Weak or no pulse in feet or legs
  • Slow hair and toe nail growth

Diagnosis:

  • Ankle-brachial index (ABI), comparing the blood pressure in the legs to the arms
  • Doppler ultrasound
  • Angiography (X-ray with contrast agent to visualize blood vessels).
  • Magnetic resonance angiography (MRA).
  • Computed tomographic angiography (CTA)
  • Weak or no pulse in feet or legs
  • Slow hair and toe nail growth

Treatment:

  • Angiography
  • Balloon angioplasty, Stents and stent-grafts.