Peripheral arterial disease (PAD) is common circulation problem in which the arteries that carry blood to the legs or arms become narrowed or clogged. This interferes with the normal flow of blood, sometimes causing pain, but often causing no symptoms that all. PAD clogged or narrowed arteries in the legs are a red flag because PAD is associated with other life-threatening vascular diseases.
Twelve to 20 percent of Americans older than 65 suffer from peripheral arterial disease but only one-third are symptomatic. Identifying pad while asymptomatic can be life-saving. Early detection by an interventional radiologist can save people from future stroke, heart attack, or an early death.
PAD Risk Factors
|Risk factors beyond your control||Aspect you can manage|
Peripheral arterial disease can be improved with lifestyle changes. Smoking cessation, diet, and exercise can improve symptoms and slow progression disease. Moving increases the distance that people with PAD can walk pain-free. Diabetes, high cholesterol, and high blood pressure can all be managed with diet and medication.
The most common symptoms arterial disease is claudication, a cramping pain in the hips, thighs, or calves that occurs when walking or exercising and disappears when the person stops the activity.
Other symptoms of PAD include:
- Numbness and tingling in the lower legs and feet
- Ulcers or sores on the legs or feet that don’t heal
- Noticeable temperature differences in your lower leg or foot, compared to the other leg of the rest of your body
Diagnosis and Treatment
There are several methods to diagnose peripheral arterial disease. The first step, your physician examines your legs and checks for a weak pulse. Next, they may use one of the following techniques:
- Ankle brachial index (ABI) – This test is a comparative blood pressure reading of the arm and ankle to determine how well your blood is flowing. It is an accurate measure of fatty plaque buildup in leg arteries and a secondary assessment of plaque accumulations in the entire cardiovascular system.
- Doppler and Ultrasound (duplex) Imaging – This is a non-invasive measure of blood flow in the artery using sound waves
- Computed Tomography Angiography (CT) – Another non-invasive test that is used to view the arteries in the abdomen, pelvis, and legs using x-ray technology. This test is especially useful for patients with a stent or pacemaker.
- Magnetic Resonance Angiography (MRA) – A test similar to CT, MRA uses magnets instead of x-rays to produce a series of images.
- Angiography – An angiogram is used to visualize blood flow, view arteries in the legs and identify blockages by injecting a contrast dye into the arteries and taking x-rays.
If a blockage is found, one or both of the following non-surgical, minimally invasive procedures can be used:
The procedure consists of the following:
- An incision is made in the leg or the neck
- A tube called the sheath is inserted in the artery
- A specially-designed catheter with a tiny balloon at the tip is guided to the blockage in the artery and inflated to increase the blood flow.
Stents are small cylinders made of a wire mesh that is implanted in an artery to help support and hold it open. Some stents include medicine, which is used to decrease the possibility of re-blockage.
This procedure is a minimally-invasive clot removal treatment:
- The stent is inserted using a balloon catheter.
- Once the stent is placed, the balloon is removed and the stent remains.
Angioplasty and stent placement usually requires a 24-hour hospital stay. Medications may be prescribed by your physician, and it may take six to eight weeks for full recovery.