Peripheral Artery Disease

Peripheral artery disease happens when arteries outside the heart and brain become narrow. This condition affects leg arteries and reduces blood flow to muscles and tissues. Peripheral artery disease impacts millions of people worldwide. People over 70 face a higher risk of developing this condition.

The vascular disease can affect anyone, but some groups face higher risks. People over 70 face a higher risk of developing this condition. Smokers and diabetics are two to four times more likely to develop circulation problems. If left untreated, patients with narrowed arteries often develop coronary artery disease, heart attacks, and strokes.

This article explains what the disease is, peripheral artery disease symptoms, modern treatment approaches, and ways to prevent the condition from developing.

What is Peripheral Artery Disease?

Blood vessels that carry blood from the heart to other body parts can become narrow or blocked in peripheral artery disease. The condition shows up in the legs more often than in the arms. People often refer to it as peripheral vascular disease (PVD) or peripheral arterial disease.

This blood vessel condition includes several acute or chronic syndromes that stem from blocked arteries. These blockages reduce blood flow to the limbs. Two-thirds of patients show unusual symptoms or no symptoms.

Symptoms of Peripheral Artery Disease

Leg pain during physical activity that gets better with rest is the classic sign of peripheral artery disease. This pain, called claudication, can show up in:

• Buttocks, hips, or thighs (suggesting narrowing in the lower aorta or iliac arteries)
• Calves (showing narrowing in femoral or popliteal arteries)

Four out of 10 people with PAD don't feel any leg pain. It also comes with other symptoms:

• Numb or weak legs
• Cold feet or toes
• Shiny skin or hair loss on affected limbs
• Brittle toenails that grow slowly
• Ulcers that take a long time to heal or don't heal

The pain can become constant in advanced stages, even without activity. Doctors call this 'rest pain'.

Causes of Peripheral Artery Disease

Atherosclerosis remains the main cause of peripheral artery disease, especially in people over 40. Fatty deposits called plaque build up inside artery walls and make them narrow and stiff.

Arteries try to widen at first to keep blood flowing despite plaque buildup. Once they can't stretch anymore, the plaque starts blocking blood flow. This blocks the blood supply resulting in ischemia. Other less common causes are:

• Blood vessel inflammation (vasculitis)
• Blood vessel injury 
• Blood vessel disorders like fibromuscular dysplasia

Diagnosis 

Doctors use several tests to diagnose peripheral artery disease: 

• Physical examination: The ankle-brachial index (ABI) test is the quickest way to screen patients by comparing blood pressure in the arms versus the ankles. A healthy ABI result shows 1.00 or greater, while results below 0.90 point to PAD.
• Doctors might order additional tests if ABI results look normal but symptoms continue:
  • Vascular ultrasound to measure blood flow speed
  • Pulse volume recording to assess blood flow in the legs
  • CT angiogram or magnetic resonance angiography to get detailed artery images

Peripheral Artery Disease Treatments 

The severity of PAD determines treatment approaches:

• Medications:
  • Blood thinners to prevent clots
  • Vasodilators to help arteries open
  • Statins to reduce cholesterol
  • Blood pressure medicines
• Exercises: Structured exercise therapy is vital for patients with mild symptoms. Patients can improve circulation by walking until leg pain occurs, resting, then resuming activity.
• Invasive procedures:
  • Angioplasty – inflating a tiny balloon to push plaque aside
  • Atherectomy – removing plaque with a catheter
  • Bypass surgery – creating new routes for blood flow

Complications of Peripheral Artery Disease

PAD can lead to limb loss without treatment. On top of that, it often occurs alongside coronary artery disease and cerebrovascular disease, which raises the risk of heart attack and stroke.

When to See a Doctor

You should contact doctors right away if you:

• Cannot feel or move your foot
• Notice major colour changes
• Feel pain in the legs at rest
• Develop ulcers on the feet or toes

Prevention of Peripheral Artery Disease

You can reduce your risk with these preventative measures:

• Quitting smoking
• Regular physical activity
• Heart-healthy diet rich in fruits, vegetables, and whole grains
• Managing conditions like diabetes and high blood pressure

These steps can lower your risk of developing this serious vascular condition by a lot.

Conclusion

Millions of people worldwide have Peripheral Artery Disease, but most don't know they have it because the symptoms are mild or nonexistent. PAD makes everyday life challenging. Blood doesn't flow well enough, so simple activities like walking become painful. The pain usually goes away with rest, but advanced PAD can hurt all the time, even when you're not moving.

PAD doesn't work alone - it's closely tied to other heart problems. When you have narrowed arteries in your limbs, your risk of heart attacks and strokes goes up by a lot. These conditions share the same risk factors, so you need detailed heart care to stay healthy.

Don't ignore leg pain during activity, wounds that won't heal, or changes in how warm or cold your feet feel. These warning signs need a doctor's attention before they get worse. Taking care of your circulation protects your quality of life, keeps you mobile, and helps you stay independent longer.

FAQs

1. Can you recover from peripheral artery disease?

You can't completely cure peripheral artery disease, but treatments work well, especially when doctors catch it early. This lifelong condition needs ongoing management through:

• Regular use of prescribed medicines
• Participation in supervised exercise programmes
• Complete tobacco cessation
• Smart food choices
• Active management of conditions like diabetes
• Quit smoking

2. What happens if a PAD is left untreated?

Peripheral artery disease can cause several serious complications without treatment:

• Reduced blood flow that causes tissue death in the legs
• Gangrene development that might require amputation
• Your stroke risk becomes three times higher
• Heart attacks and coronary artery disease become more likely
• Many patients with critical limb ischemia need amputation within a year

3. What is the most common cause of peripheral arterial disease?

Atherosclerosis is the main cause. This condition starts when fatty materials (plaque) build up in your artery walls and narrow them gradually. Your risk increases with:

• Smoking
• Diabetes
• High blood pressure
• High cholesterol

4. What is the natural treatment for peripheral artery disease?

Natural treatments focus on changing your lifestyle:

• Structured exercise therapy - walk until pain occurs, rest, then continue
• Healthy meals with less saturated fat and more fibre
• Good hydration to maintain circulation
• Weight control

Dr. Alok Kumar Udiya

MBBS, MD, PDCC (Neuro-radiology and Gastro-radiology)
CARE CHL Hospitals, Indore

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