PERIPHERAL ARTERY DISEASE (PAD)

Description

  • Narrowed arteries reduce blood flow to the limbs
  • Caused by a build-up of fatty deposits in the arteries
  • Commonly affects people with type 2 diabetes

Symptoms

  • Painful cramping in the hip, thigh or calf muscles (claudication)
  • Leg numbness or weakness
  • Coldness in the lower leg or foot
  • Sores on the toes, feet or legs that won’t heal
  • A change in the color of the legs
  • Hair loss or slower hair growth on the feet and legs
  • Slower growth of the toenails
  • Shiny skin on the legs
  • No pulse or a weak pulse in the legs or feet
  • Erectile dysfunction in men

Causes

  • Often caused by atherosclerosis
  • Blood vessel inflammation
  • Injury to the limbs
  • Unusual anatomy of the ligaments or muscles
  • Radiation exposure

Risk Factors

  • Smoking
  • Diabetes
  • Obesity (a body mass index over 30)
  • High blood pressure
  • High cholesterol
  • Increasing age, especially after reaching 50 years of age
  • A family history of peripheral artery disease, heart disease or stroke
  • High levels of homocysteine
  • Physically inactive
  • Previous history of heart attack or stroke

Diagnostic Tests

  • Physical examination
  • Ankle-brachial index (ABI)
  • Doppler ultrasound
  • Magnetic resonance angiography (MRA)
  • Computerized tomography angiography (CTA)
  • Blood tests

Treatment

Lifestyle changes:

  • Quit smoking
  • Exercise regularly
  • Eat a healthy diet
  • Maintain a healthy weight
  • Cut down on alcohol

Medications:

  • Cholesterol-lowering medications
  • High blood pressure medications
  • Medication to control blood sugar
  • Medications to prevent blood clots
  • Symptom-relief medications

Angioplasty and surgery:

  • Angioplasty
  • Bypass surgery
  • Thrombolytic therapy

Medications

  • Pentoxifylline (Trental)
  • Clopidogrel (Plavix)
  • Cilostazol (Pletal)

Prevention

  • Quit smoking
  • If diabetic, keep blood sugar in good control
  • Exercise regularly
  • Lower the cholesterol and blood pressure levels, if applicable
  • Eat foods that are low in saturated fat

Lifestyle Management

  • Stop smoking
  • Maintain a healthy weight
  • Eat a healthy diet
  • Avoid certain cold medications like those containing pseudoephedrine