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Peripheral Artery Disease

Peripheral artery disease (PAD) in the legs or lower extremities is the narrowing or blockage of the vessels that carry blood from the heart to your limbs. It is primarily caused by the buildup of fatty plaque in the arteries, which is called atherosclerosis. PAD can happen in any blood vessel, but it is more common in the legs than the arms.

When you develop PAD, your legs or arms—usually your legs—don't receive enough blood flow to keep up with demand. This may cause symptoms, such as leg pain (claudication) when walking.

What happens once you have peripheral artery disease?

The classic symptom of PAD is pain in the legs with physical activity, such as walking, that gets better after rest. However, up to four in ten people with PAD have no leg pain. Symptoms of pain, aches, or cramps with walking tend to happen in the buttock, hip, thigh, or calf.

Physical signs in the leg that may indicate PAD include:

  • Hair loss.

  • Weak muscles.

  • Cold or numb toes.

  • Smooth, shiny skin.

  • Decreased or absent pulses in the feet.

  • Sores or ulcers in the legs or feet that don’t heal.

  • Skin that is cool to the touch, especially if accompanied by pain while walking (that is relieved by stopping walking).

What causes peripheral artery disease?

PAD is often caused by atherosclerosis. In atherosclerosis, fatty deposits build up on your artery walls and reduce blood flow. Although discussions of atherosclerosis usually focus on the heart, the disease can and usually does affect arteries throughout your body.

Both men and women are affected by PAD; however, African Americans have an increased risk of PAD. Hispanics may have similar to slightly higher rates of PAD compared with non-Hispanic white people. Approximately 6.5 million people age 40 and older in the United States have PAD.

Other health conditions and disorders of arteries can mimic PAD symptoms, and not all PAD is due to atherosclerosis.

If you have PAD, you are at risk of developing coronary artery disease and cerebrovascular disease, leading to a heart attack or stroke.

What types of tests are used to diagnosis peripheral artery disease?

If you have PAD symptoms, your doctor may do an ankle brachial index (ABI), which is a noninvasive test that measures the blood pressure in the ankles and compares it with the blood pressure in the arms at rest and after exercise.

Your doctor may also do imaging tests such as ultrasound, magnetic resonance angiography (MRA), and computed tomographic (CT) angiography.

What types of treatments and procedures are used to treat peripheral artery disease?

Treatment for PAD focuses on reducing symptoms and preventing it from getting worse. In most cases, lifestyle changes, exercise, and claudication medications are enough to stop it or even reverse PAD symptoms.

Your doctor may recommend that you take aspirin or other similar antiplatelet medicines. You may also need to take medication to reduce your blood cholesterol. You may need surgery to bypass blocked arteries.

What can I do to support my health when I have peripheral artery disease?

In most cases, lifestyle changes, exercise, and claudication medications are enough to slow the progression or even reverse PAD symptoms. Here are some tips:

  • Reduce salt in your diet.

  • Maintain a healthy body weight.

  • Never smoke, or stop smoking.

  • Drink only moderate amounts of alcohol, if any. This means an average of one to two drinks per day for men and one drink per day for women.

  • Eat a healthy, well-balanced diet, rich in fresh fruit and vegetables but low in saturated fats, processed sugar, and salt.

  • If you have diabetes, work closely with your doctor to make sure it is controlled.

  • Get plenty of physical activity to help prevent PAD or improve symptoms of PAD. Participating in exercise training programs can improve your ability to walk longer distances.

Why choose Presbyterian for peripheral artery disease treatment?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.