Peripheral Artery Disease

Peripheral artery disease (PAD), or peripheral arterial disease, is the narrowing of blood vessels outside of the heart.

Usually a result of a hardening of the arteries called atherosclerosis, PAD occurs 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.

Those with PAD have a higher risk for heart disease and stroke, and it can be a warning sign for diabetes and high blood pressure, among other conditions. 

Risk Factors

Some general risk factors for peripheral artery disease, include:

• Smoking
• High blood pressure
• Atherosclerosis
• Diabetes
• High cholesterol
• Being over 60 years old

Prevention

You can prevent PAD through lifestyle changes, including:

• Stop smoking. Smoking can increase the risk of PAD and make the symptoms worse.
• Start exercising. Physical activity and exercise can prevent PAD and improve the symptoms of PAD.
• Eating healthier. A healthy diet can help control weight, blood pressure and cholesterol.

Symptoms

Some symptoms of PAD can include: 

• 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.

Treatments

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