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What is Peripheral Arterial Disease (PAD)?

Peripheral arterial disease, also known as peripheral vascular disease, is a common vascular condition in which blood supply to the limbs is reduced due to the narrowing of arteries.

Causes of Peripheral Arterial Disease (PAD)

Peripheral arterial disease is caused by the accumulation of fat, calcium, and cholesterol in the arterial wall (atherosclerosis), resulting in reduced blood flow - and therefore oxygen - to the limbs. Some common factors include:

  • High cholesterol
  • Smoking
  • High blood pressure
  • Diabetes
  • Emotional stress
  • Obesity
  • Family history of heart disease
  • Increased age
  • Drugs
  • Kidney failure

Symptoms of Peripheral Arterial Disease (PAD)

Symptoms of the peripheral arterial disease include:

  • Ulcers on the legs
  • Fatigue
  • Muscle cramps
  • Slow toenail growth
  • Erectile dysfunction
  • Pale or even bluish color of the toes (cyanosis)
  • Hair loss
  • Cold skin on the feet
  • Burning sensation

Diagnosis of Peripheral Arterial Disease (PAD)

Your doctor will review your medical history and symptoms and conduct a physical examination to check for a whooshing sound in the leg. Your doctor may also recommend the following diagnostic tests:

  • Magnetic Resonance Angiogram (MRA): This study uses a large magnetic field and radio waves to produce images of the blood vessels. 
  • Magnetic Resonance Imaging (MRI): This study uses a large magnetic field and radio waves to produce cross-sectional images of soft-tissue structures such as the aorta.
  • Ankle-brachial index (ABI): This test helps to compare the blood pressure of the ankle with the arm.
  • Doppler ultrasound: This test measures the quality of blood flow through the blood vessels.
  • Angiogram: This is an imaging test that uses a long, thin, flexible catheter that is passed through the bloodstream along with contrast dye to visualize blood flow in the arteries and veins. This also detects any plaque formation within the blood vessels.
  • Blood tests: These tests help to determine the levels of cholesterol and C-reactive protein in the blood.

Treatment for Peripheral Arterial Disease (PAD)

The major goal of the treatment of peripheral arterial disease is to manage symptoms and prevent the progression of the disease. The most common treatment methods include:

Lifestyle Changes

  • Quitting smoking: This mitigates the worsening of any peripheral arterial disease.
  • Following a balanced diet: Adhering to a diet that is high in fiber and low in cholesterol.
  • Medications: Your doctor will recommend cholesterol-lowering, anti-platelet, and anti-coagulant medications.
  • Controlling diabetes: Maintaining blood sugar levels helps to reduce the risk of PAD.
  • Physical exercise: Your doctor will recommend a supervised exercise training program that helps your muscles to use oxygen effectively and increases circulation.

If conservative methods fail to improve the symptoms, the following surgeries may be recommended:

  • Angioplasty: This minimally invasive procedure involves placing a catheter into the artery, then inflating a balloon at the catheter tip to open the lumen and allow more blood flow.
  • Thrombolytic therapy: In this therapy, certain drugs are used to help dissolve blood clots within the artery.
  • Peripheral artery bypass surgery: A blood vessel from another part of the body is used to create a graft to bypass the blocked artery and improve peripheral blood flow.

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