Peripheral Artery Disease (PAD, Vascular Disease, Atherosclerosis)

Peripheral Artery Disease (PAD) is a condition where the arteries that carry blood to your limbs, especially your legs, become narrowed or blocked (Figure 1). Peripheral artery disease is also often called vascular disease or atherosclerosis. Imagine a garden hose that gets clogged up with dirt or hard material limiting or even stopping the flow of water. This is akin to peripheral artery disease. PAD happens because of a buildup of fatty deposits, called plaque, inside the artery walls, which reduces blood flow. PAD usually affects the legs and can cause symptoms like leg pain, cramping, or tiredness, especially when walking or exercising, but it goes away with rest. People who are more likely to get PAD include those who smoke, have high blood pressure, high cholesterol, or diabetes. It’s also more common in older adults, especially over the age of 50, and in people who are overweight or have a family history of heart disease. If left untreated, peripheral artery disease can lead to serious problems like infections or even the need to amputate part, or all, of a limb.

Diagnosing Peripheral Artery Disease

Peripheral Artery Disease (PAD) is diagnosed by a doctor through a combination of questions about your symptoms, a physical exam, and special tests. One common test is the Ankle-Brachial Index (ABI), where the doctor compares the blood pressure in your ankle to the blood pressure in your arm. A lower blood pressure in your ankle could mean you have PAD. The doctor might also use ultrasound, which uses sound waves to check how well blood is flowing through your arteries. In some cases, they might do imaging tests like a CT angiogram or MRI angiogram, where a dye is injected into your blood vessels to help show any blockages. These tests help doctors see how much the arteries are narrowed and how severe the PAD is, so they can decide on the best treatment.

Treatment of Peripheral Artery Disease

Peripheral Artery Disease (PAD) is usually treated by making lifestyle changes and using medications to improve blood flow and prevent the disease from getting worse. Doctors often recommend quitting smoking, eating a healthy diet, exercising regularly (like walking), and losing weight if needed. These changes can help improve circulation. Medications like cholesterol-lowering drugs, blood pressure medicines, and blood thinners may be prescribed to reduce the risk of heart attacks or strokes. In more severe cases, doctors might suggest procedures like angioplasty, where a tiny balloon is used to open up blocked arteries, or even surgery to bypass the blocked areas. The goal of treatment is to reduce pain, improve blood flow, and prevent serious complications.

Edited by Stephen Pinney MD November 12th, 2024