Peripheral artery disease (PAD) is a condition in which one or more of the arteries supplying blood to the legs (or arms) become blocked or partially blocked, usually because of atherosclerosis. A person with PAD may experience symptoms if the blood flow to the limbs is no longer sufficient to keep up with the demand.
Key points
Symptoms of Peripheral Artery Disease (PAD)?
The most common symptom of Peripheral Artery Disease is “claudication.” Claudication is pain, cramping, or discomfort—which can vary from merely annoying to quite severe—that occurs in the affected limb. Typically, claudication occurs during exercise and is relieved by rest.
Since PAD most commonly affects the legs, claudication most typically manifests as leg pain when walking. Depending on where in the leg artery the blockage is located, leg claudication can affect the foot, calf, thigh, or buttocks. People who have Peripheral Artery Disease in one of the arteries that supply the upper extremities can experience claudication in the arm or shoulder; and some can even experience neurological symptoms during arm exercise, a condition called “subclavian steal syndrome.”
Sometimes PAD will cause persistent claudication even at rest.
Resting claudication often means that the arterial blockage is relatively severe, and the affected limb is not receiving sufficient blood flow even at rest.
Because claudication does not always follow the typical pattern—that is, pain during exertion, with relief during rest—the diagnosis of PAD should be considered any time a person over 50 years of age, who has risk factors for atherosclerosis, experiences unexplained pain in the arms or legs.
Very severe Peripheral Artery Disease can lead to ulceration and even gangrene of the affected limb.
What Causes Parkinson’s Disease?
In the large majority of cases, Peripheral Artery Disease is caused by atherosclerosis. This means that the same kinds of risk factors that cause coronary artery disease (CAD)—especially elevated cholesterol levels, smoking, hypertension, and diabetes—also produce PAD. In fact, because PAD and Coronary Artery Disease are caused by the same process, when PAD is diagnosed, very often it means that Coronary Artery Disease is also present.
More rarely, PAD can be seen in people who do not have atherosclerosis. For instance, Peripheral Artery Disease can be caused by trauma to the limbs, exposure to radiation, and certain drugs (the ergotamine drugs) used to treat migraine headaches.
How Is Peripheral Artery Disease Detected?
PAD can be diagnosed with non-invasive testing. In some cases, PAD can be detected by physical examination when a reduced pulse is noticed in the affected limb. More often than not, however, one of several specific tests is required to diagnose PAD.
Diagnosing PAD in the legs can be done using the “Ankle Brachial Index,” or ABI, in which the blood pressure is measured and compared between the ankle and the arm. A low Ankle Brachial Index index indicates a reduced blood pressure in a leg artery, indicating that PAD is present.
“Plethysmography” is another technique used for diagnosing Peripheral Artery Disease. With this test, air is pumped into a series of cuffs placed along the leg, and the pulse pressure of the artery beneath each cuff is estimated. Abblockage somewhere in the artery will result in a reduced pulse pressure beyond the area of blockage.
“Duplex ultrasonography” is a special ultrasound test that provides an estimate of blood flow at various levels within an artery. A sudden drop in blood flow suggests a partial blockage in the area of the drop.
If your doctor suspects PAD, one or more of these non-invasive tests is usually sufficient to make a diagnosis. Today, the Ankle Brachial Index is the test used most commonly.
How is Peripheral Artery Disease Treated?
While mild or moderate Peripheral Artery Disease can be treated with medication and lifestyle changes, more severe cases often require bypass surgery or angioplasty to relieve the blockages.
