Diagnosing and Treating Peripheral Artery Disease
Peripheral artery disease (PAD), or peripheral arterial disease, is the narrowing of blood vessels outside of the heart.
PAD usually develops as a result of a hardening of the arteries called atherosclerosis. This happens when cholesterol and scar tissue build up to form a substance called plaque, which narrows and clogs the arteries. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking and eventually gangrene and amputation.
People with PAD are at a higher risk for heart disease and stroke. PAD is also a marker for diabetes, high blood pressure and other conditions.
General risk factors for PAD include:
- High blood pressure
- High cholesterol
- Age over 60
Lifestyle changes can help prevent PAD, including:
- Quitting smoking. Smoking increases the risk of PAD and makes the symptoms of PAD worse.
- Exercise. Physical activity and exercise are important for preventing PAD and improving symptoms of PAD.
- Eating well. A healthy diet can help control weight, blood pressure and cholesterol.
People with PAD may experience a variety of symptoms, such as:
- Leg pain when walking or exercising that stops when resting
- Foot or toe wounds that won't heal or heal slowly
- Coldness in the lower legs and feet
- Poor nail growth on the toes or hair growth on the legs
- Erectile dysfunction, especially in men with diabetes
Detection and Diagnosis
There are several diagnostic tests that can detect PAD. These include:
- Ankle-Brachial Index — This painless exam compares the blood pressure in your feet to the blood pressure in your arms to determine how well your blood is flowing. An unusual difference may indicate PAD.
- Doppler Ultrasound — This noninvasive method visualizes the artery with sound waves and measures the blood flow in an artery to indicate blockages.
- Computed Tomographic Angiography (CTA) — This noninvasive test shows the arteries in your abdomen, pelvis and legs. It can be useful for patients with pacemakers or stents.
- Magnetic Resonance Angiography (MRA) — This noninvasive test gives information similar to that of a CT without using X-rays.
- Angiogram — During an angiogram, or an arteriogram, a contrast agent is injected into the artery and X-rays are taken to show blood flow, the arteries in the legs and to pinpoint any blockages.
Treatment options for PAD include:
- Lifestyle changes, such as quitting smoking, eating a healthy diet and exercising
- Medication, including cholesterol and blood pressure medications
- Angioplasty to restore blood flow to the artery
- Heart bypass surgery
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