Peripheral Artery Disease: How Do Your Arteries Hold Up Over Time?

Peripheral artery disease (PAD) is a slow disease process that results in plaque buildup in the arteries over time. It can affect the arms and legs. However, the legs and feet tend to be where this disease is most recognizable. This disease is common in patients who smoke or have a history of smoking, diabetes, high blood pressure, or high cholesterol. There are other risk factors associated with PAD, but these are some of the primary contributors.

What Symptoms Can Develop?

PAD can manifest as pain in the muscles that are supplied by the arteries beyond the blockage. Imagine a dam across a large river with all of the gates open. If these gates were to begin to close one by one, less water would get downriver. If the muscles cannot get the blood flow that they need to function properly, they will begin to suffer, and this is initially demonstrated by fatigue or pain with walking.

As this process progresses, patients will experience what is referred to as “rest pain,” and this manifests most commonly at night. Due to the blockages and the distance from the heart, blood cannot properly get to the feet, resulting in pain. Lastly, wounds can be affected or develop from peripheral artery disease. If healthy tissue does not get proper blood flow, it can prevent sores from healing or result in sores. Many recognize this latter process as gangrene.

How Is PAD Diagnosed?

The initial diagnosis can be identified by a patient’s story. The next step involves an ultrasound or doppler study to better evaluate the blood flow. This is a noninvasive study that can give a provider an idea of the degree of circulation compromise, which may contribute to the symptoms. A CT angiogram may also be necessary to give additional information.

What Can Be Done To Prevent Or Limit PAD?

Lifestyle modifications such as not smoking, exercise, and management of medical issues with assistance of a primary care provider are always the initial treatments to reduce a patient’s risk and limit disease progression. Exercise can promote collateralization. This process is our body’s natural way to combat peripheral artery disease by developing smaller arteries around the blockage.

If these lifestyle modifications do not help, other options can involve medications that can widen or dilate the vessels in an attempt to get more blood flow beyond the blockage.

Lastly, surgical management can play a role. This involves a minimally invasive outpatient procedure called an angiogram where a small puncture is made in the artery and wires, as well as catheters, can be used to not only identify but also treat significant arterial blockages to get more blood flow to affected areas. There are times when these “endovascular” procedures cannot treat the blockages and more invasive surgical options may be necessary as well.

If you are developing leg pain with walking, pain in your feet at night, or sores on your legs or feet that seem to take a long time to heal, it may be worth discussing peripheral artery disease with your primary care provider or contacting a vascular surgery provider to further evaluate this.

For more information, go to www.vascularsurgeryassociates.net or call Vascular Surgery Associates at 410-946-6402.