Peripheral artery disease (PAD) is a circulatory health condition in which blood flow to the limbs becomes reduced because of narrowed or blocked arteries. PAD can cause symptoms of pain and cramping in the limbs and has a variety of preventive measures and treatment options.
PAD is a health problem that can occur in any blood vessel, but it more commonly affects the legs than the arms. PAD is primarily caused by atherosclerosis, the buildup of fatty plaque deposits in the arteries.
Your limbs need a certain amount of blood to be healthy and to function properly. With PAD, blood flow is reduced and the amount of blood that is able to circulate to the limbs can’t keep up with the body’s needs.
PAD can lead to more serious health problems, including increased risk for stroke and heart attack. It’s a relatively common condition, affecting more than 6.5 million people in the U.S. over the age of 40. Fortunately, you can take measures to reduce the risk of PAD and treatment is available for those who have it.
PAD can affect both men and women, but some people may have a higher risk for developing it. African American and Hispanic people are at a higher risk of developing PAD, according to the Centers for Disease Control and Prevention (CDC).
The primary cause of PAD is atherosclerosis, the buildup of fatty plaque deposits in the arteries, but there are many factors that can increase risk, including:
- High blood pressure (hypertension)
- High cholesterol (hypercholesterolemia)
- Renal failure
- Family history of heart disease
- Age over 60 years
Some less common causes of PAD include inflammation of the blood vessels, injury to the limbs, radiation exposure, or unusual anatomy of the ligaments or muscles.
One of the most recognized symptoms of PAD is pain or cramping in the limbs. It happens more often when walking, exercising, or doing strenuous activity, and it usually goes away with rest. This type of cramping or pain associated with exercise is called claudication. The calf is the most common location for this type of pain.
Other signs of PAD include:
- Leg numbness or weakness
- Painful cramping in one or both of your thighs, hips, or calf muscles after certain activities
- Sores that won’t heal on your feet, toes, or legs
- Coldness in the lower leg or foot
- A change in skin color or shiny skin on the legs
- Slower toenail growth
- Slower hair growth or hair loss on your legs and feet
- Weak pulse in the legs or feet
- Erectile dysfunction in men
As PAD progresses, you may feel pain even when you’re at rest and it can sometimes be severe enough to disrupt your sleep.
PAD comes with serious health risks. People with PAD are at increased risk for developing coronary artery disease and cerebrovascular disease, which can lead to heart attack, stroke, or transient ischemic attack (TIA), a stroke that lasts only a few minutes.
The buildup of plaque in the arteries can also lead to critical limb ischemia—non-healing open sores on the feet and legs. If not treated properly, the progression of tissue damage or infection can even cause the need for amputation.
Treatment for PAD has two primary goals:
- To manage symptoms like leg pain and enable you to resume physical activities.
- To stop the progression of atherosclerosis to other parts of the body and reduce risks for heart attack and stroke.
You may be able to accomplish treatment goals using lifestyle changes, especially if the disease is still in an early stage. Here are the top steps you can take:
- If you smoke—quit!
- Exercise regularly. Even brisk walking every day can help manage symptoms.
- Make sure other health conditions are properly managed, especially high blood pressure, high cholesterol, and diabetes.
If your PAD is more advanced, you may need additional medical treatment, which can include supervised exercise therapy, medications, and minimally-invasive procedures. It’s important to talk with a specialist to make sure you have the right diagnosis and treatment.
Prescription medications for PAD may be used to prevent blood clots, reduce blood pressure or cholesterol, control blood sugar, and to manage pain and other symptoms.
Sometimes, minimally-invasive treatments may be recommended. Some procedures used for the treatment of PAD include balloon angioplasty, atherectomy, and/or stenting.
Balloon angioplasty is used to open narrowed or blocked peripheral arteries. In balloon angioplasty, a tiny needle is placed into your artery, usually in your hip area, and a flexible catheter is inserted through the needle into the artery. Using specialized x-ray fluoroscopy guidance, a miniature balloon on the catheter’s tip is inflated to reopen the constricted artery and enhance blood flow.
Atherectomy can be used with an angioplasty or on its own. Using a catheter with an attached cutting tool, the surgeon will remove or destroy the blockage in the artery.
Stenting is often recommended to help hold open a weakened artery. A stent is made from wire mesh that’s tube-shaped and open on both ends. Stents reinforce blood vessel walls at an area of previous blockage. You can expect to remain under medical observation for a few hours following these minimally-invasive procedures, but they are performed on an outpatient basis, so you can go home the same day.
PAD is not uncommon, but can lead to severe health complications and should be taken seriously. At Beach Wellness MD, our primary focus is on restoring your health and improving your quality of life.
Dr. Ali Golshan, MD, is a leading vascular expert who specializes in PAD and other vascular conditions. Dr. Golshan emphasizes one-on-one treatment and designs personalized care plans for each patient.
Contact us today to schedule your appointment.