Peripheral Artery Disease: Insights into Treatment and Prevention

Peripheral artery disease (PAD) refers to the accumulation of plaque in the arteries of your legs. These arteries are crucial in transporting oxygen and nutrients from your heart to your arms and legs. This condition affects 6.5 million Americans approximately. If left untreated, PAD can lead to amputation of your leg, foot, or arm (very rare). Fortunately, timely diagnosis and treatment can help prevent the condition from aggravating, reducing potential complications.

This blog discusses everything about PAD, covering its causes, symptoms, stages, diagnosis, and treatments, helping you make an informed decision.

How Does Peripheral Artery Disease Impact Blood Flow?

PAD occurs when plaque, consisting of fat, cholesterol, and other substances, gradually builds up inside the walls of your arteries, reducing the blood flow. The accumulation of plaque in the arteries is known as atherosclerosis. Over time, this narrowing of the arteries can lead to hard plaque deposits that may crack or tear, allowing platelets to gather and form blood clots. These blood clots can further restrict blood flow, potentially causing damage and even gangrene to the tissues below the blockage, most commonly affecting the toes and feet.

Causes and Risk Factors of Peripheral Artery Disease 

Common causes of PAD include:    

• Atherosclerosis   
• Radiation exposure   
• Changes in the muscles or ligaments    
• Blood vessel inflammation
• Injury to the arms or legs

Here are the factors that increase the risk of developing PAD:

• Age above 60 years
• High blood pressure and cholesterol  
• Smoking 
• Diabetes
• A personal or family history of blood vessel or heart disease 
• Blood clotting disorder   
• Abdominal obesity   
• Kidney disease

Symptoms of Peripheral Artery Disease 

PAD often presents mild or even no symptoms. However, some people may experience leg pain while walking (claudication). Claudication causes mild to severe muscle discomfort or cramping in the legs (in the calf area) or arms, typically starting during physical activity and subsiding with rest. Intense pain in the legs can significantly impact walking or engaging in physical exercises.

Other typical PAD symptoms include:

• Coldness in the lower leg or foot 
• Painful cramps in one or both thighs, hips, or calf muscles after walking or climbing stairs
• Slower growth of the toenails
• Shiny skin on the legs
• Hair loss or slower hair growth on the legs    
• Leg numbness or weakness   
• No pulse or a weak pulse in the legs or feet     
• Erectile dysfunction  
• Skin discoloration on the legs·        
• Sores on the toes, feet, or legs that won't heal     
• Aching or cramping pain in the arms when writing, knitting, or doing other manual tasks

Stages of Peripheral Artery Disease

• Asymptomatic: Refers to plaque accumulation in the arteries without any apparent symptoms. It can be identified through an imaging study.
• Intermittent Claudication: Characterized by limb pain or cramping in the calves, thighs, and buttocks during physical activity and subsides with rest. It results from constricted arteries that fail to deliver an adequate supply of oxygen-rich blood to the muscles.       
• Critical Limb Ischemia: Presents more severe obstructions in the arteries and skin problems such as ulcers, wounds, or gangrene. You may feel discomfort or pain in your feet or toes, even when you are not active. Symptoms often worsen during the night or when the affected limb is elevated. A medical intervention is usually necessary to avoid irreversible physical damage.
• Acute Limb Ischemia: Develops abruptly, even without any prior peripheral artery problems, leading to a rapid and severe reduction in blood flow to a limb. A slow pulse, limb paralysis, cold skin, tingling or numbness in limbs, and pale skin characterize it. Immediate medical attention is necessary to prevent permanent damage or limb loss.

Is Peripheral Artery Disease Life-Threatening?

Yes, PAD is life-threatening, as it can lead to restricted blood circulation in the limbs and organs. Inadequate blood flow can damage vital organs, legs, arms, and feet. If not addressed promptly, the affected tissue may become infected or necrotic, a condition known as gangrene. The gangrene can cause infection, necessitating amputation. Otherwise, the infection can spread to other body parts and become life-threatening. Untreated PAD can also elevate the likelihood of developing heart attack, coronary artery disease, and stroke.

Diagnosis of Peripheral Artery Disease 

Your provider will review your medical history and symptoms and perform a physical exam that includes checking pulse in the affected area, as PAD causes slow or no pulse. Also, they may order the following tests for a complete diagnosis:   

• Blood Tests: To determine risk factors of PAD, such as high triglycerides, high cholesterol, and high blood sugar.  
• Ultrasound of the Legs or Feet: It uses sound waves to check how blood flows in the blood vessels. Doppler ultrasound works to detect blocked or narrowed arteries.
• Angiography: This test uses imaging techniques to look for artery blockages. Before the X-ray, dye (contrast) is injected into a blood vessel to help show arteries more clearly on the test images.  
• Ankle-Brachial Index (ABI): It compares the blood pressure in the ankle with the blood pressure in the arm before and after walking on a treadmill to check the arteries' function.

Treatment of Peripheral Artery Disease

Depending on the causes, symptoms, and severity of your condition, your provider may recommend any of the following treatment options:

Medications

Your provider may prescribe medications to treat leg pain, cholesterol, blood sugar, blood clots, and blood pressure.

Surgery 

• Thrombolytic Therapy: A clot-dissolving drug is injected into the affected area to treat a blood clot.       
• Bypass Surgery: Involves using a healthy blood vessel from another part of the body or a synthetic one to create a path around the blocked artery.     
• Angioplasty and Stent Placement: Opens clogged arteries while detecting and treating a blocked vessel.

How to Prevent PAD?

• Eat a healthy diet.
• Maintain a healthy weight.      
• Quit smoking.   
• Avoid medications containing pseudoephedrine, which narrows blood vessels.
• Exercise regularly.   
• Take good care of your feet.

Final Thoughts

As peripheral artery disease (PAD) is a severe condition that affects the blood flow to the limbs, most commonly the legs, early diagnosis and treatment can reduce the risk of amputation and other complications associated with the condition. Besides, simple lifestyle changes such as quitting smoking, adopting a healthy diet, and regular exercise can help prevent PAD.

Experience High-Quality PAD Treatment at North Atlanta Vascular Clinic!

North Atlanta Vascular Clinic is a leading facility with a team of experienced specialists dedicated to providing top-notch PAD treatment. With advanced technology and a comprehensive treatment approach, we improve blood circulation and alleviate symptoms associated with PAD. Contact us today to achieve optimal vascular health.