Peripheral artery disease (PAD)

What is it?

Peripheral artery disease, or PAD, refers to disease of the blood vessels (arteries and veins) located outside the heart and brain. PAD is commonly referred to as peripheral vascular disease, a condition that develops when the arteries that supply blood to your internal organs, arms and legs become completely or partially blocked as a result of fatty deposits (atherosclerosis). The disease most commonly impacts the legs and feet.

Peripheral artery disease is a chronic condition that can be treated, but not cured.

Symptoms

• Intermittent aching, heaviness, cramping or weakness in the buttocks, legs or calves; often occurs while walking or exercising yet disappears with rest (claudication)
• Leg numbness or weakness
• Coldness in your lower leg or foot
• Sores, wounds or ulcers on your legs that won’t heal
• Change in color or shiny skin on your legs
• No pulse or a weak pulse in your legs or feet
• Erectile dysfunction in men

Risk factors

• Current smoking or smoking history
• Diabetes
• Age; especially if you’re older than 50
• High cholesterol
• High blood pressure
• History of heart disease
• Obesity; generally defined as a BMI over 30

Diagnosing PAD

• Complete medical history and physical examination.
• Ankle-brachial index: This commonly used, non-invasive test compares the blood pressure in your ankle with the blood pressure in your arm.
• Doppler ultrasound: This procedure evaluates blood flow through your blood vessels to identify blocked or narrowed arteries.
• Angiogram: By injecting contrast dye into your blood vessels, this test allows your doctor to view blood flow through your arteries.

Treating PAD

• Control symptoms to prevent disease progression.
• Lower your risk by not smoking, eating a healthy diet and being active.
• Management of chronic conditions such as diabetes, high blood pressure and/or high cholesterol.
• Supervised exercise therapy through cardiac rehabilitation.
• Medications to:
  • Improve blood flow.
  • Slow your heart rate.
  • Lower your blood pressure.
• Procedures to restore blood flow
  • Endovascular procedures which are minimally-invasive and use catheters.
  • Surgical procedures in which the patient’s chest is surgically opened such as bypass or coronary artery bypass grafting.