What is Peripheral Artery Disease (PAD)

Peripheral artery disease ( also referred to as peripheral arterial disease) is a prevalent circulatory problem in which arteries reduce flow into your limbs.

When you develop peripheral artery disease (PAD), your limbs – normally your legs, do not receive enough blood flow to keep yours with demand. This causes symptoms, most notably leg pain when walking (claudication)

The peripheral artery disease is likewise to be a sign of a more widespread buildup of fatty deposits in your arteries (atherosclerosis) This condition may be decreasing blood flow to your heart and brain, as well as your legs.

Often, you can, fortunately, manage peripheral artery disease by stop smoking tobacco, exceeding and eating a healthy diet.

Although many individuals with peripheral artery disease have mild or no symptoms, some people have leg pain when walking (claudication)

Claudication symptoms comprise of muscle pain or cramping in your legs or arms that’s triggered by exercise, such as jogging but leaves after a few minutes of rest. The position of the pain depends on the location of the clogged or narrowed artery. Calf pain is the most common location.

The severity of elucidation varies broadly, from mild discomfort to debilitating pain, Severe claudication can make it heard for you to walk or do other types of physical activity

Peripheral artery disease symptoms include:

  • Leg numbness or weakness
  • A change in color of your legs
  • Coolness in your lower leg or foot, specially when compared with another side
  • Leg numbness or weakness
  • Hair loss or slower hair growth on your legs or feet and legs
  • Shiny skin on your legs
  • Slower growth of your toenails
  • Skinny skin on you legs
  • Erectile dysfunction in men
  • No Pulse or a weak pulse in your legs and feet

If peripheral artery disease progresses, pain may even occur when you are at rest or when you are lying down (ischemic rest pain). It may be invested enough to disrupt sleep. Hanging your legs over the edge of your bed or walking around your room may temporarily relieve the pain.

When should you see your doctor
If you have leg pain or numbness or other symptoms, do not dismiss them as a normal part of aging. Call your doctor and make an appointment.
Even if you do not have symptoms of peripheral artery disease, you may need to be screened if you ar:
Over age 70
Over 50 years old and have a history of diabetes or smoking
Under 50 years old, but have diabetes, and other peripheral artery ideas risk factors such as obesity or high blood pressure

Peripheral artery disease is often formed by atherosclerosis. In atherosclerosis, fatty deposit(plaque) build up in your artery walls and reduce blood flow.

Although the heart is normally the focus of discussion of atherosclerosis, this disease can and often does affect arteries throughout your body When it cooks in the arteries supplying blood to your limbs, it causes peripheral artery disease.

Less generally, the cause of peripheral artery disease may be blood vessel swelling, injury to your limbs, unusual anatomy of your ligaments or muscles, or radiation exposure.

Risk Factors

  • Diabetes
  • Smoking
  • High Cholesterol
  • High Blood pressure
  • High levels of homocysteine, a protein element that helps build and maintain tissue
  • A family history of the peripheral artery disease, heart disease or stroke.
  • Obesity (a body mass index over 30)

People who smoke or have diabetes have the highest risk of developing peripheral artery dise3ae due to reduced blood flow.

If your peripheral artery disease is triggered by a buildup of plaques in your blood vessels (atherosclerosis) you are also of developing:

Stroke and heart attack. Atherosclerosis that creates the signs and symptoms of the peripheral artery disease is not limited to your legs. Fat deposits also build up in arteries providing your heart and brain.
Critical limb ischemia. This condition begins as open sores that don;t heal, an injury, or an infection of your legs or feet. Critical limb ischemia transpires when such injuries or infection progress, a can cause tissue death (gangrene) sometimes requiring amputation of the affected limb.

DiagnosisSome of the tests your doctor may rely on to diagnose peripheral artery diseases are:

  • Physical exam. Your physician may find symptoms of PAD during a physical examination such as a light or absent pulse below a tight area of your artery. Whooshing sounds (bruits) covering your arteries that can be heard with a stethoscope, indication of poor wound healing in the area where your blood flow is limited and reduced blood pressure in your affected limb.
  • Ankle-brachial index (ABI) This is a general test used to diagnose PAD. It equates the blood pressure in your ankle with the blood pressure in your arm.To get a blood pressure results, your doctor uses a regular blood pressure cuff and a special ultrasound equipment to evaluate blood pressure and flow.
    You may walk on a treadmill and have readings taken before and shortly after exercising to understand the severity of the narrowed arteries during walking.
  • Ultrasound. Special ultrasound imaging methods such as Doppler ultrasound can help your doctor evaluate blood flow through your blood vessels and distinguish blocked or narrowed arteries.
  • Angiography – By injecting a dye (contrast material) into your blood vessels, this test allows your physician to view blood flow through your arteries as it happens. Your physician can trace the movement of the contrast material using imaging techniques such as X-ray imaging or producers called Magnetic Resonance(vibration) angiography (MRA) or computerized tomography angiography CTA.
  • Catheter angiography is a more invasive undertaking that involves guiding a catheter within the artery in your groin to the affected area and injecting a dye that way. Even though it’s an invasive process, an angiography allows for simultaneous diagnosis and treatment -finding the narrowed area of a blood vessel and then stretching it with a dilating procedure for administering medication to improve blood flow.

Blood test. A unit of your blood can be used to regulate your cholesterol and triglycerides and to check for diabetes.

PAD treatment

Treatment for peripheral artery disease has two primary goals.
Manage symptoms, such as leg pain, so that can you continue physical activities.
Stop the rise of atherosclerosis throughout your body to reduce your risk of heart attack and stroke.

You may be able to achieve these goals with lifestyle changes. If you smoke, quitting is a single most important thing you can do to reduce the risk of complications.

If lifestyle changes are not sufficient, you will need additional medical treatment. Your doctor may prescribe medicine to prevent blood clots, lower blood pressure and cholesterol, and control pain and other symptoms.

Cholesterol- lowering medications, You may take a cholesterol-lowering medicine referred to as statin to decrease your risk of heart attack and stroke.

The goal for people who have peripheral artery disease to lessen low-density lipoprotein (LDL) cholesterol, the bad cholesterol, to less than 100 milligrams per deciliter (mg/Dl), or 2.6 millimoles per liter (mmoI/L). The goal is even lower if you have further risk factors for heart attack and stroke, especially diabetes or continued smoking.

High blood pressu

re drugs. IF you also have high blood pressure, your physician may prescribe medications to lower it.

The goal of people therapy is to reduce your systolic blood pressure (the top number or the two numbers) to 140 millimeters of mercury (mm Hg) or lower and your diastolic blood pressure (the bottom number) to 90 mm Hg or lower. If you have diabetes, your blood pressure goal is under 130/80 mm Hg.

Medication to control blood sugar – If you also have diabetes, it becomes even more critical to monitor your blood sugar (glucose) levels, Discuss with your doctor about what your blood sugar goals are and what steps your need to take to achieve these goals.

Medications to prevent blood clots. Because peripheral artery disease is related is reduced blood flow to your limbs, it’s important to improve tat flow.
Your doctor may be designated daily aspirin therapy or another medication, such as clopidogrel (Plavix).
Symptom-relief medicines. The drug cilostazol (palatal) increases blood flow to the limbs both by keeping the blood thin and by widening the blood vessels. It particularly helps improve symptoms of claudication, such as leg pain, for people who have peripheral artery disease. Common side effects of this medication include a headache and diarrhea.
An alternative to cilostazol is pentoxifylline (Trental) however, it’s less effective. But side effects are rare with this medication.

Angioplasty and surgery

In some cases, angioplasty or surgery may be needed to treat peripheral artery disease that causes claudication:
Angioplasty, In this procedure, a small empty tube (catheter) is threaded through a blood vessel to affected artery. There a little balloon on the tip of the catheter is inflated to repeal the artery and flatten the obstruction into the artery wall, while at the same time stretching the artery open to increase blood flow.

Your physician may also implant a mesh framework referred to as a stent in the artery to help keep it open. This is the same surgical technique doctors use to open heart arteries.

Bypass surgery – Your doctor may produce a graft bypass using a vessel from another portion of your body or a blood vessel constructed of synthetic fabric. This technique permits blood to flow around – or bypass – the blocked or narrowed artery.

Thrombolytic therapy. If you gave a blood clot blocking an artery, your doctor might inject a clot-removing medication into your artery at the point of the clot to break it up.