Are you at risk for peripheral arterial disease (PAD)?

 Peripheral arterial disease (PAD) involves damage to or blockage in the blood vessels that carry blood away from your heart—the peripheral arteries. Your peripheral arteries carry blood to your arm and leg muscles and the organs in and below your stomach area. PAD may also affect the arteries leading to your head; this is called Carotid Artery Disease.

What causes arterial blockage?
PAD can result from a condition known as atherosclerosis, where a waxy substance forms inside of the arteries. This substance is called plaque. It is made of cholesterol, fats, calcium, and a blood-clotting material called fibrin.

When enough plaque builds up on the inside of an artery, the artery becomes clogged, and blood flow is slowed or stopped. This slowed blood flow may cause "ischemia," which means that your body's cells are not getting enough oxygen. While clogged coronary arteries (the arteries that supply your heart with blood) may lead to a heart attack, and clogged carotid arteries (the arteries that supply your head with blood) may lead to a stroke, clogged peripheral arteries in the lower part of the body most often cause pain and cramping in the legs.

The risk factors for atherosclerosis in the peripheral arteries are the same as those for atherosclerosis in the coronary arteries. Smoking, diabetes, high blood pressure, and high cholesterol are believed to lead to the development of plaque.

What are the symptoms and signs?
Patients may feel pain in their calves, thighs, or buttocks, depending on where the blockage is. Usually, the amount of pain you feel is a sign of how severe the blockage is.  Sometimes leg cramps develop when a person walks, and the leg pain usually gets worse with increased activity. This cramping is called claudication.  Like the chest pain of angina, the leg pain of claudication usually goes away with rest. Cold temperatures and some medicines may also cause leg pain.  In serious cases, your toes may turn a bluish color, your feet may be cold, and the pulse in your legs may be weak. In some cases, the tissue dies (this is called gangrene) and amputation may be needed.


How is an arterial blockage diagnosed?

Doctors can make a diagnosis by listening to you describe your symptoms and by checking for a weak pulse in the arteries in your feet. Further tests may include:
•Ultrasound, which is a test that uses sound waves to produce an image of blood flow through your arteries.
•Angiography, which is a test that may be performed if your doctor thinks your condition is serious enough for a minimally invasive transcatheter intervention such as angioplasty, or even surgery. The test uses a harmless dye that is injected into the arteries. It lets doctors see where and how serious the blockage is.

How is a blockage treated?
When the blockages are not severe, this form of PAD can be controlled by losing weight, quitting smoking, and following a regular exercise program that has been approved by your doctor.

A transcatheter intervention is a minimally invasive treatment, such as balloon angioplasty or a peripheral stent, and may be needed for a severely blocked artery that is causing pain or other symptoms.

Your doctor may also recommend a surgical procedure called a peripheral vascular bypass. This procedure creates a way for blood to flow around one or more of the narrowed vessels. After making an incision in your arm or leg or below your stomach, the surgeon will take an artificial vessel or one of your own veins (called a graft) and connect it to the blocked vessel at points above and below the blockage. This allows blood to flow around, or "bypass," the blockage.  Today, it is becoming more common to treat blockages in the arteries with minimally invasive procedures such as angioplasty, instead of performing a surgery.   Check with your doctor to discuss the best alternatives for you, if you have PAD.  Call CFIM today for a free screening!

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