Peripheral Vascular Disease (PAD)
Peripheral Artery Disease (PAD), is caused by atherosclerotic plaque that builds up in the arteries in the extremities of the body, such as the legs. Frequently atherosclerosis, or the plaque build-up, is found in more than one artery. PAD affects nearly 10 million adult Americans according to the American Heart Association.

What are the symptoms of Peripheral Artery Disease?
As the internal lining of the artery thickens from the atherosclerotic plaque, the blood vessel becomes increasingly constricted and blood flow diminishes. Therefore, the symptoms you may experience depend on what artery is affected and how severely the blood flow is reduced.
Some of the symptoms you may experience in the affected areas are:

• Claudication (dull, cramping pain in hips, thighs or calf muscle) 
• Infection/sores that do not heal 
• Ulceration or gangrene

Clinical studies have identified factors that increase the risk of PAD. Some of these factors cannot be changed, while others can be managed to greatly reduce your risk of the disease. They are as follows:

• Diabetes: PAD is common among those individuals with diabetes. This correlation is due to complications of the disease, which may cause damage to the large and small blood vessels of the legs and feet. 
• Smoking: The risk of PAD dramatically increases in smokers. When a person stops smoking, regardless of how much he or she may have smoked in the past, their risk of P A D rapidly declines.

Any of the following risk factors may also increase your chance of developing P A D:

• Obesity (being overweight) 
• High blood pressure 
• A family history of the disease
• Lack of exercise 
• Coronary artery disease
• Age greater than 65 
• Hyperlipidemia (high cholesterol)

How is PAD diagnosed?
If your doctor suspects that you have PAD, or if you have symptoms of the disease, several tests are performed to diagnosis it. Such diagnostic tests include:

• Ankle Brachial Index (ABI)
• Doppler Ultrasound Test
• CAT Scan or MRI
• Angiogram

What are the treatments of PAD?
Many treatments can be used to improve blood flow through the peripheral arteries. The latest interventions for treating PA D can bring relief and are more cost effective than surgery. Most procedures require no more than an overnight hospital stay, and patients enjoy an early return to most normal activities. Techniques available to you include:

Angioplasty and stents 

• Atherectomy - a minimally invasive intervention procedure that involves the excision and removal of blockages by catheters with miniature cutting systems.
  All of these techniques treat the build-up of plaque by either removing it, compressing it or displacing it. During these procedures, the physician will periodically inject a contrast dye and take x-ray pictures to determine whether or not the artery is sufficiently open. If the blockage is extremely long or has become very hard and calcified with time, it may be resistant to any of these procedures. In these cases, surgery may be required to bypass the problem area.

Other important measures that may be used to treat PAD include:

• Exercise - exercise may improve arterial blood flow to the affected limb. Exercise is not recommended for people with severe pain at rest, venous ulcers or gangrene. Consult your doctor before beginning an exercise program.
• Stop Smoking - Smoking causes vasoconstriction (decreases the diameter of blood vessels), which can interfere with adequate blood flow to the limbs. Emotional stress, exposure to cold temperatures and caffeine can all cause vasoconstriction.
• Medications – Medications that are occasionally prescribed to patients with P A D include antiplatlet medications (such as Aspirin and Plavix), those that increase blood flow (Cilostazol (Pletal)) or cause vasodilation (calcium channel blockers such as Amlodipine or Verapamil).

 

Information on this page is courtesy of The Christ Hospital of Cincinnati, Ohio.