Peripheral Artery Disease (PAD) develops when the arteries of your lower extremities become clogged with plaque (known as atherosclerosis). The plaque that forms in the arteries of the leg also forms in the arteries of the brain and heart. The plaque causes the arteries to become blocked, which reduces the blood flow from your heart and brain to your limbs. This condition raises the risk for heart attack, stroke, leg amputation, and even death.
One in every 20 Americans over the age of 50 has PAD and it affects 8 to 12 million people in the United States. Fortunately, there are symptoms of PAD which typically act as warning signs to the disease. Jon M. Wesley, M.D., a vascular surgeon at Vascular Specialist of Central Florida, says PAD can actually cause tissue to die as the disease worsens.
“Because PAD restricts blood flow to the organs, the symptoms are related to what organs are affected. So the symptoms are related to the inability for the muscles to get the oxygen that they need to do what they normally do, like walking,” he explains. “The most important and early symptoms are pain in the legs while walking. As the reduction of blood flow becomes more and more severe, the pain starts to happen at shorter and shorter distances. In its worst form, PAD will be painful at rest and sores will develop on the feet as the tissue actually starts to die.”
The symptoms felt in the lower extremities include but are not limited to:
- Pain in the leg while walking
- Cramping in the hip, thigh and calf
- Leg numbness and weakness
- Coldness of lower leg and foot (compared to other leg)
- Sores on toes, feet or legs that won’t heal
- Shiny skin on your legs
- No pulse, or a weak pulse in your legs or feet
The reason many potential patients are left untreated for PAD is because they dismiss their symptoms as signs of aging. If you are experiencing leg pain, numbness or other symptoms it’s recommended you consult with a physician as soon as possible.
Certain risk factors increase the chances of developing PAD according to Dr. Wesley.
“The two most important risk factors are smoking and diabetes. Hypercholesterolemia (high cholesterol), high blood pressure and genetics also influence who is at risk for developing PAD,” he says.
The idea behind the treatment for PAD is to stop the progression of the disease while creating a healthier lifestyle. Lifestyle adjustments are effective for many diagnosed with PAD. Exercising helps condition your muscles to use oxygen more efficiently and eating a healthy diet can help control your blood pressure and cholesterol levels (which contribute to atherosclerosis). When simple lifestyle changes are not effective, there are medications to help prevent development of plaque and to help lower cholesterol.
Dr. Wesley says, “The most important treatment for PAD is changing our lifestyles. Exercise and certain medications may increase our ability to walk further distances. The most important thing is to control our cholesterol, [if you smoke] stop smoking and [if you have diabetes] control our diabetes. In severe cases, angioplasty, atherectomy and maybe even bypass surgery may be used to create better blood flow down to the tissue.”
If the lifestyle adjustments or medications are ineffective, surgery will most likely be considered. The following procedures help restore blood flow through the artery:
- Angioplasty is a procedure where the doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end, which inflates once the tube is in place. The balloon pushes the plaque outward against the wall of the artery. The artery becomes widened and blood flow is restored.
- Atherectomy is a procedure that utilizes a catheter with a sharp blade on the end to remove plaque from a blood vessel. The artery is punctured slightly to allow the catheter to be inserted. The catheter is designed to collect the removed plaque in a chamber in the tip, which allows removal of the plaque as the device is removed from the artery. This procedures eliminates the blockage of plaque inside the arteries.
- Bypass surgery improves the blood flow to the heart, by providing a new route” around a section of clogged or diseased artery.